Healthcare Provider Details

I. General information

NPI: 1942333620
Provider Name (Legal Business Name): PHYSICAL THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 10/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 AVE AMERICO MIRANDA
SAN JUAN PR
00921-2801
US

IV. Provider business mailing address

PO BOX 56
MANATI PR
00674-0056
US

V. Phone/Fax

Practice location:
  • Phone: 787-756-6868
  • Fax: 787-767-8484
Mailing address:
  • Phone: 787-756-6868
  • Fax: 787-767-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA MALDONADO
Title or Position: PRESIDENT
Credential: RPH,CPOA, CFOM,CDME
Phone: 787-756-6868