Healthcare Provider Details

I. General information

NPI: 1376524751
Provider Name (Legal Business Name): ROSANA I. VILLAFANE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CALLE 30 SE REPARTO METROPOLITANO
SAN JUAN PR
00921-2323
US

IV. Provider business mailing address

1 CALLE VILLEGAS PORTICOS DE GUAYNABO, APTO.17102
GUAYNABO PR
00971-9201
US

V. Phone/Fax

Practice location:
  • Phone: 787-274-8176
  • Fax:
Mailing address:
  • Phone: 787-274-8176
  • Fax: 787-274-8176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1181
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: