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General NPI Number Information
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NPI Number | 1801232004
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Entity Type | Organization
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Legal Business Name | MARIA PALOU PHYSIATRIC SERVICES, PSC
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | # 2 MANUEL GARCIA BAJOS
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-3063
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Country | US
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Telephone | 787-733-1222
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Fax | 787-733-1310
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Provider Business Mailing Address
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Address Line | # 2 MANUEL GARCIA BAJOS
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-3063
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Country | US
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Telephone | 787-733-1222
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Fax | 787-733-1310
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA INES PALOU-AVILES
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Credential | M.D.
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Telephone | 787-733-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 11325
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License Number State | PR
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