Provider Demographics
NPI:1255482410
Name:CLINICA ESPECIALIZADA EN REHABILITACION FISICA Y MEDICINA DEPORTIVA
Entity Type:Organization
Organization Name:CLINICA ESPECIALIZADA EN REHABILITACION FISICA Y MEDICINA DEPORTIVA
Other - Org Name:CERFIMED, CSP
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:GARCIA-NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-473-9344
Mailing Address - Street 1:89 CALLE AMAPOLA
Mailing Address - Street 2:URB JARDINES DE NARANJITO
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719-4413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:89 CALLE AMAPOLA
Practice Address - Street 2:URB JARDINES DE NARANJITO
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-4413
Practice Address - Country:US
Practice Address - Phone:787-473-9344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15847208100000X
PR1273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty