Provider Demographics
NPI:1972554210
Name:SALINAS-SEINE, GLORIA EJ (MPT)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:EJ
Last Name:SALINAS-SEINE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-0167
Mailing Address - Country:US
Mailing Address - Phone:787-760-1223
Mailing Address - Fax:787-767-7370
Practice Address - Street 1:124 AVE WINSTON CHURCHILL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6064
Practice Address - Country:US
Practice Address - Phone:787-767-7370
Practice Address - Fax:787-767-7370
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50099OtherPREFERRED MEDICARE CHOICE
PR820568OtherMMM
PR9260301OtherHUMANA HEALTH PLAN
PR3304329OtherACAA
PR9260301OtherHUMANA HEALTH PLAN REFORM
PR61799OtherTRIPLE C
PR9260301OtherHUMANA HEALTH PLAN