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NPI Code Detail

MEDICARE: M.C. THERAPY CENTER LLC

MEDICARE: M.C. THERAPY CENTER LLC
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1881204287
Entity Type Code : Organization
Provider Name (Legal Business Name) : M.C. THERAPY CENTER LLC
Provider Business Mailing Address
First Line : HC 7 BOX 76350
Second Line :
City : SAN SEBASTIAN
State : PR
Zip : 00685-7366
Country : US
Telephone Number : 787-464-0810
Fax Number :
Provider Business Practice Location Address
First Line : 66 CALLE MJ CABRERO
Second Line :
City : SAN SEBASTIAN
State : PR
Zip : 00685-4843
Country : US
Telephone Number : 787-464-0810
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MARITZA CORDERO GONZALEZ
Credential : OTR/L
Telephone Number : 787-464-0810
Provider Enumeration Date : 07/31/2020
Last Update Date : 09/10/2024

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