Provider Demographics
NPI:1346245032
Name:BUTLER MOYA, LUZ C (MPT)
Entity Type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:C
Last Name:BUTLER MOYA
Suffix:
Gender:F
Credentials:MPT
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 430
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-0430
Mailing Address - Country:US
Mailing Address - Phone:787-846-4121
Mailing Address - Fax:787-846-5661
Practice Address - Street 1:CARR #2 KM 55 2
Practice Address - Street 2:BO PALENQUE
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-0430
Practice Address - Country:US
Practice Address - Phone:787-846-4121
Practice Address - Fax:787-846-4121
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR909225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89230OtherTRIPLE C REFORMA
PR2182OtherINTERNATIONAL MEDICAL CA
PR223165OtherPREFERRED HEALTH CARE
PR9002161OtherCRUZ AZUL
PR223165OtherPREFERRED HEALTH PLAN
PR50015AOtherPREFERRED MEDICARE CHOICE
PR6400178OtherHUMANA
PR73422OtherICMS
PR870027OtherMMM
PR29795OtherAMPR
PRS64473Medicare UPIN
PR9002161OtherCRUZ AZUL
PR223165OtherPREFERRED HEALTH PLAN