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General NPI Number Information
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NPI Number | 1356595128
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Entity Type | Organization
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Legal Business Name | J.W. GOVEO P.S.C. MEDICAL SERVICES
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | EDIFCIO LAS VEGAS # 420 BARRIO COTTO NORTE
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City | MANATI
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State | PR
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Zip | 00674
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Country | US
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Telephone | 787-310-9731
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Fax | 787-626-7842
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Provider Business Mailing Address
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Address Line | 425 CARR. 693 PMB 103
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-439-4892
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Fax | 787-626-7842
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Authorized Official
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Title or Position | INCUMBANT DIRECTOR
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Name | MRS. WENDY LOUNSBERRY GOVEO
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Credential | DPT
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Telephone | 787-439-4892
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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 | 13010
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License Number State | PR
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