Provider Demographics
NPI:1104792407
Name:DS CORNERSTONE PHYSIATRY LLC
Entity type:Organization
Organization Name:DS CORNERSTONE PHYSIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-379-4066
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-1327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 CARR 188 KM 1.5 PARCELAS NUEVAS
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-9787
Practice Address - Country:US
Practice Address - Phone:786-256-1358
Practice Address - Fax:787-985-9332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty