Healthcare Provider Details

I. General information

NPI: 1154454759
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: 07/17/2007
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 TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JOSE A HERNANDEZ
Title or Position: PRESIDENT
Credential: BOCOP,C,PED,RPT
Phone: 787-756-6868