Provider Demographics
NPI:1033120654
Name:ROBERT SANTIAGO FIGUEROA
Entity Type:Organization
Organization Name:ROBERT SANTIAGO FIGUEROA
Other - Org Name:CONCEPTO FISICO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-864-8471
Mailing Address - Street 1:PO BOX 900
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785
Mailing Address - Country:US
Mailing Address - Phone:787-864-8471
Mailing Address - Fax:787-866-6558
Practice Address - Street 1:CALLE DUQUE #5
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-8471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083962Medicare PIN