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General NPI Number Information
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NPI Number | 1568462117
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Entity Type | Organization
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Legal Business Name | FISIOTERAPIA EN LA MONTANA
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | URB PARQUE CENTRAL EDIF MEDICO 401 SUITE 5A
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City | SAN JUAN
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State | PR
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Zip | 00917
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Country | US
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Telephone | 787-862-7548
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Fax | 787-862-7703
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Provider Business Mailing Address
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Address Line | URB PARQUE CENTRAL EDIF MEDICO SUITE 5A
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City | SAN JUAN
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State | PR
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Zip | 00917
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Country | US
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Telephone | 787-772-7731
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR / PT
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Name | MR. ALEX GONZALEZ
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Credential | LPT
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Telephone | 787-862-7548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 11945
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License Number State | PR
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