Provider Demographics
NPI:1174641005
Name:YADIRA GUADALUPE AMADOR
Entity Type:Organization
Organization Name:YADIRA GUADALUPE AMADOR
Other - Org Name:CENTRO DE TERAPIA FISICA DEL NORTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FISIOTERAPISTA
Authorized Official - Prefix:MRS
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUADALUPE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:787-820-4776
Mailing Address - Street 1:PO BOX 621
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0621
Mailing Address - Country:US
Mailing Address - Phone:787-820-4776
Mailing Address - Fax:787-820-4776
Practice Address - Street 1:STREET # 2 KM.94.5
Practice Address - Street 2:BO. YEGUADA
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-820-4776
Practice Address - Fax:787-820-4776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR827261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherFEDERAL ID