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General NPI Number Information
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NPI Number | 1811202161
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Entity Type | Organization
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Legal Business Name | CLINICA DE TERAPIA FISICA VILLA REAL INC
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | CARR 2 MARGINAL D18 URB VILLA REAL
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City | VEGA BAJA
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State | PR
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Zip | 00693-0000
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Country | US
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Telephone | 787-654-8400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1423
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City | VEGA BAJA
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State | PR
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Zip | 00694-1423
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Country | US
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Telephone | 787-654-8400
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. JAVIER RIVERA
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Credential | MD
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Telephone | 787-644-4499
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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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