MEDICARE: PHYSICS REHAB CENTER

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	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962054395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICS REHAB CENTER

Provider Business Mailing Address
First Line	:	B38 CALLE NORTH VIEW COURT
Second Line	:	URB BALDWIN PARK
City	:	GUAYNABO
State	:	PR
Zip	:	00969
Country	:	US
Telephone Number	:	787-288-0808
Fax Number	:	787-288-0888

Provider Business Practice Location Address
First Line	:	ID14 CALLE ALMACIGO
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00956-3104
Country	:	US
Telephone Number	:	787-288-0808
Fax Number	:	787-288-0888

Authorized Official
Title or Position	:	PRESIDENTE
Name	:	DR. OMAR GOMEZ MEDINA
Credential	:	MD
Telephone Number	:	787-288-0808

Provider Enumeration Date	:	07/16/2019
Last Update Date	:	06/29/2020

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Directions to “PHYSICS REHAB CENTER ” Practice Location

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