Provider Demographics
NPI:1235480559
Name:CUERVO FERNANDEZ, NERVA M (PT)
Entity Type:Individual
Prefix:
First Name:NERVA
Middle Name:M
Last Name:CUERVO FERNANDEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-0192
Mailing Address - Country:US
Mailing Address - Phone:787-475-2227
Mailing Address - Fax:
Practice Address - Street 1:1045 CAMINO CLINICA ESPANOLA
Practice Address - Street 2:CLINICA ESPANOLA
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5388
Practice Address - Country:US
Practice Address - Phone:787-831-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist