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General NPI Number Information
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NPI Number | 1568136695
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Entity Type | Organization
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Legal Business Name | TERAPIAS INTERDISCIPLINARIAS DE EXCELENCIA EN SERVICIO CORP.
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | CARR 111 KM 1.2 BO PUEBLO INT 436 AVE LOS PATRIOTAS
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City | LARES
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State | PR
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Zip | 00669
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Country | US
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Telephone | 787-203-2186
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 3787
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City | LARES
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State | PR
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Zip | 00669-9611
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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 | VIRMARYS QUINONES - IRIZARRY
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Credential |
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Telephone | 787-203-2186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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