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General NPI Number Information
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NPI Number | 1821212978
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Entity Type | Organization
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Legal Business Name | ELOI PHYSICAL THERAPY PSC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 39 CALLE RAMON TORRES
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City | FLORIDA
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State | PR
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Zip | 00650-2040
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Country | US
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Telephone | 787-466-9466
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Fax | 787-822-0710
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Provider Business Mailing Address
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Address Line | PO BOX 2083
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City | HATILLO
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State | PR
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Zip | 00659-9083
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Country | US
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Telephone | 787-466-9466
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Fax | 787-822-0710
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Authorized Official
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Title or Position | PRESIDENT
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Name | SOFIA VAZQUEZ CHACON
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Credential | PT
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Telephone | 787-466-9466
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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 | 1216
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License Number State | PR
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