MEDICARE: MS. AIXA AIMEE TORT 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	261QP2000X	Physical Therapy Clinic/Center	1317	PR
2	225100000X	Physical Therapist	1317	PR

General Provider Information

NPI Number	:	1750441556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AIXA AIMEE TORT P.T.

Provider Business Mailing Address
First Line	:	1733 CALLE THEIS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3200
Country	:	US
Telephone Number	:	787-602-0686
Fax Number	:	787-294-1265

Provider Business Practice Location Address
First Line	:	1733 CALLE THEIS
Second Line	:	RIO PIEDRAS HEIGHTS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3248
Country	:	US
Telephone Number	:	787-692-3646
Fax Number	:	787-294-1265

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	08/31/2022

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