Provider Demographics
NPI:1104011857
Name:CARRASQUILLO, LIZBETH GOMEZ I (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:LIZBETH
Middle Name:GOMEZ
Last Name:CARRASQUILLO
Suffix:I
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:COND. LES JARDIN
Mailing Address - Street 2:APT. 116
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-2200
Mailing Address - Country:US
Mailing Address - Phone:787-391-1303
Mailing Address - Fax:
Practice Address - Street 1:COND. LES JARDIN
Practice Address - Street 2:APT. 116
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-2200
Practice Address - Country:US
Practice Address - Phone:787-391-1303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR1192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist