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General NPI Number Information
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NPI Number | 1629552419
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Entity Type | Organization
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Legal Business Name | VICTORIA MARIEL THERAPY LLC
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 959 CALLE MUNOZ RIVERA
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City | PENUELAS
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State | PR
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Zip | 00624-1401
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Country | US
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Telephone | 787-651-6714
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Fax | 787-651-6714
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Provider Business Mailing Address
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Address Line | PO BOX 68
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City | PENUELAS
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State | PR
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Zip | 00624-0068
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Country | US
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Telephone | 787-651-6714
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Fax | 787-651-6714
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Authorized Official
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Title or Position | PRESIDENTA
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Name | MRS. AGNES M RAMOS
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Credential |
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Telephone | 787-651-6714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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