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General NPI Number Information
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NPI Number | 1669739595
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Entity Type | Organization
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Legal Business Name | CENTRO DE TERAPIA FISICA BOAZ VEGA BAJA
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 04/17/2012
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Provider Practice Location Address
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Address Line | CARR. # 2 KM. 39.9 PLAZA JARDINES SUITE # 2
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-858-4845
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Fax | 787-858-4845
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Provider Business Mailing Address
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Address Line | PO BOX 558
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City | GARROCHALES
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State | PR
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Zip | 00652-0558
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Country | US
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Telephone | 787-858-4845
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Fax | 787-858-4845
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MS. SYLVIA E OTERO RODRIGUEZ
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Credential |
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Telephone | 787-858-4845
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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 | 797
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License Number State | PR
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