Provider Demographics
NPI:1194775338
Name:CLINICA DE TERAPIA FISICA Y REHABILITACION
Entity type:Organization
Organization Name:CLINICA DE TERAPIA FISICA Y REHABILITACION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:787-874-1449
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:NAGUABO
Mailing Address - State:PR
Mailing Address - Zip Code:00718-0070
Mailing Address - Country:US
Mailing Address - Phone:787-874-1449
Mailing Address - Fax:787-874-1449
Practice Address - Street 1:45 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718-2222
Practice Address - Country:US
Practice Address - Phone:787-874-1449
Practice Address - Fax:787-874-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3310174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherMCS