Provider Demographics
NPI:1316971948
Name:ROBLES-FIGUEROA, MYRNA LUZ (PT)
Entity type:Individual
Prefix:MRS
First Name:MYRNA
Middle Name:LUZ
Last Name:ROBLES-FIGUEROA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VILLA DELICIAS
Mailing Address - Street 2:CALLE GIMNASIA #4329
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-3716
Mailing Address - Country:US
Mailing Address - Phone:787-318-5150
Mailing Address - Fax:787-260-0034
Practice Address - Street 1:BO. AMUELAS #115
Practice Address - Street 2:CARR. 592 KM. 5.6
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2872
Practice Address - Country:US
Practice Address - Phone:787-837-6574
Practice Address - Fax:787-260-0034
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0057731Medicare ID - Type Unspecified
PRQ66946Medicare UPIN