MEDICARE: ALICIA CORREA R.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	452	PR

General Provider Information

NPI Number	:	1154397941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA CORREA R.P.T.

Provider Business Mailing Address
First Line	:	PO BOX 999
Second Line	:
City	:	RIO GRANDE
State	:	PR
Zip	:	00745-0999
Country	:	US
Telephone Number	:	787-256-1358
Fax Number	:	787-256-1358

Provider Business Practice Location Address
First Line	:	CARR 188 KM 1.5 PARCELAS NUEVAS
Second Line	:	BARRIO SAN ISIDRO
City	:	CANOVANAS
State	:	PR
Zip	:	00729-0000
Country	:	US
Telephone Number	:	787-256-1358
Fax Number	:	787-256-1358

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	03/25/2011

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Directions to “ ALICIA CORREA R.P.T.” Practice Location

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