Provider Demographics
NPI:1013394006
Name:CENTRO DE TERAPIAS YABISI, PSC
Entity Type:Organization
Organization Name:CENTRO DE TERAPIAS YABISI, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:MARRERO
Authorized Official - Last Name:ALFONZO
Authorized Official - Suffix:
Authorized Official - Credentials:THL
Authorized Official - Phone:787-597-6367
Mailing Address - Street 1:PO BOX 1035
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-1035
Mailing Address - Country:US
Mailing Address - Phone:787-597-6367
Mailing Address - Fax:
Practice Address - Street 1:CALLE 2 KM 93.3
Practice Address - Street 2:BO MEMBRILLO
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-597-6367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14402355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR351988OtherTREASURY DEPARMENT