Provider Demographics
NPI:1063517563
Name:BRITO-HERNANDEZ, MARTA (RPT)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:BRITO-HERNANDEZ
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 CALLE MONTREAL
Mailing Address - Street 2:OLIMPIC VILLE
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-9696
Mailing Address - Country:US
Mailing Address - Phone:787-644-5074
Mailing Address - Fax:787-258-3212
Practice Address - Street 1:201 CALLE GAUTIER BENITEZ
Practice Address - Street 2:SUITE 308
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-258-3275
Practice Address - Fax:787-258-3212
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1141OtherRPT LICENSE