Provider Demographics
NPI:1588891303
Name:CENTRO FISIATRICO DEL CARIBE PSC
Entity type:Organization
Organization Name:CENTRO FISIATRICO DEL CARIBE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:F
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-538-1386
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0746
Mailing Address - Country:US
Mailing Address - Phone:787-969-1969
Mailing Address - Fax:787-851-2552
Practice Address - Street 1:CARR 100 KM 6.1 INT.
Practice Address - Street 2:BO. MIRADERO
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-0746
Practice Address - Country:US
Practice Address - Phone:787-969-1969
Practice Address - Fax:787-851-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14734208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty