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General NPI Number Information
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NPI Number | 1528122694
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Entity Type | Organization
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Legal Business Name | CENTRO TERAPIA FISICA RIVERA NIEVES INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | ST. 693 BARRIO BRENAS SUITE NO 271
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-883-3939
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Fax | 787-270-4933
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Provider Business Mailing Address
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Address Line | PO BOX 19
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City | DORADO
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State | PR
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Zip | 00646-0019
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Country | US
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Telephone | 787-883-3939
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Fax | 787-270-4933
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Authorized Official
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Title or Position | OWNER FOR THERAPY CENTER
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Name | LILLIANA RIVERA NIEVES
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Credential | THERAPIST
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Telephone | 787-883-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 1046
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License Number State | PR
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