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General NPI Number Information
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NPI Number | 1457742322
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Entity Type | Organization
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Legal Business Name | CENTRO DE TERAPIA FISICA RENACE
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 05/24/2015
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Provider Practice Location Address
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Address Line | 3623 AVE. MILITAR ISABELA ISABELA PROFESSIONAL BUILDING, SUITE 102
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 787-454-7888
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Fax | 787-872-3232
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Provider Business Mailing Address
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Address Line | 2410 CALLE GOLONDRINA COMUNIDAD CAPIRO
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City | ISABELA
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State | PR
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Zip | 00662-4526
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Country | US
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Telephone | 787-454-7888
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Fax | 787-872-3232
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Authorized Official
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Title or Position | OWNER
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Name | DARYNELI PEREZ
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Credential |
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Telephone | 787-454-7888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | PR
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