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General NPI Number Information
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NPI Number | 1518241389
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Entity Type | Individual
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Provider Name | ROSAMARIA MONTENEGRO PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | CALLE 9 D-33 URBANIZACION VALPARAISO
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City | TOA BAJA
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State | PR
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Zip | 00949-4037
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Country | US
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Telephone | 787-366-1401
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Fax |
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Provider Business Mailing Address
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Address Line | CRISANTEMO IG-2 ROYAL PALM URB ROYAL PALM
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City | BAYAMON
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State | PR
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Zip | 00956-3111
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Country | US
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Telephone | 787-366-1401
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1414
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License Number State | PR
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