Healthcare Provider Details

I. General information

NPI: 1750627840
Provider Name (Legal Business Name): INSTITUTO DE REHABILITACION DEL CARIBE, C.S.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 CALLE CONVENTO
SANTURCE PR
00912-3207
US

IV. Provider business mailing address

264 CALLE CONVENTO
SANTURCE PR
00912-3207
US

V. Phone/Fax

Practice location:
  • Phone: 787-723-7554
  • Fax: 787-723-7554
Mailing address:
  • Phone: 787-723-7554
  • Fax: 787-723-7554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number11778
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number11778
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number11778
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number11778
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number11778
License Number StatePR

VIII. Authorized Official

Name: MR. EDWARDO RAMOS
Title or Position: PRESIDENT
Credential: M.D
Phone: 787-723-7554