Provider Demographics
NPI:1336889914
Name:ABREU VALENTINO, JOSE RAMON (LMT, LPT, MBA)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RAMON
Last Name:ABREU VALENTINO
Suffix:
Gender:M
Credentials:LMT, LPT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR-10 BOX 101 44C
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-647-4107
Mailing Address - Fax:
Practice Address - Street 1:108 ROBERTO CLEMENTE AVE.
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-647-4107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1978-10981208171400000X
PR1978-13000208171400000X
PR000163225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach