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General NPI Number Information
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NPI Number | 1730276254
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Entity Type | Individual
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Provider Name | ANNIE-LEE TIRADO MPT, MS, CSCS
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | RD 106 FLOR DEL VALLE 665 AMAPOLA ST
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-806-3438
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Fax | 787-833-4570
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Provider Business Mailing Address
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Address Line | PO BOX 3635
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City | MAYAGUEZ
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State | PR
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Zip | 00681-3635
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Country | US
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Telephone | 787-806-3438
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Fax | 787-833-4570
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 001296
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License Number State | PR
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