Provider Demographics
NPI:1295046027
Name:JRA ALTERNATIVE REHAB PSC
Entity Type:Organization
Organization Name:JRA ALTERNATIVE REHAB PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:RODRIGUEZ ARCHILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-208-2366
Mailing Address - Street 1:SENDEROS EN MONTEHIEDRA
Mailing Address - Street 2:CALLE MALAQUITA, #31
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-208-2366
Mailing Address - Fax:
Practice Address - Street 1:126 AVE DE DIEGO
Practice Address - Street 2:SEIN MEDICAL PLAZA, SUITE 202
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3036
Practice Address - Country:US
Practice Address - Phone:787-208-2366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-26
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16252208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty