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General NPI Number Information
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NPI Number | 1982976536
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Entity Type | Organization
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Legal Business Name | PHYSIOTHERAPY REHABILITATION SERVICES, INC
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Dates
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Enumeration Date | 01/29/2012
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | URB SANTA JUANITA UU43 CALLE 30
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City | BAYAMON
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State | PR
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Zip | 00956-4701
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Country | US
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Telephone | 787-787-8669
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Fax | 787-786-7865
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Provider Business Mailing Address
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Address Line | PO BOX 444
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City | BAYAMON
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State | PR
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Zip | 00960-0444
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Country | US
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Telephone | 787-787-8669
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Fax | 787-786-7865
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUSTAVO J MOREY CRUZ
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Credential | DPT
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Telephone | 787-787-8669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number | 406504
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License Number State | PR
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