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General NPI Number Information
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NPI Number | 1205222999
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Entity Type | Organization
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Legal Business Name | NORTH COAST REHAB LLC
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 1451 AVE ASHFORD
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City | SAN JUAN
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State | PR
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Zip | 00902
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Country | US
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Telephone | 787-722-2915
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70344 PMB 296
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City | SAN JUAN
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State | PR
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Zip | 00936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIANELA CUADRADO
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Credential | MD
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Telephone | 787-619-9686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 14601
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License Number State | PR
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