Provider Demographics
NPI:1346344058
Name:RIOS CORUJO, JOANNE (PT)
Entity Type:Individual
Prefix:MISS
First Name:JOANNE
Middle Name:
Last Name:RIOS CORUJO
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 192445
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2445
Mailing Address - Country:US
Mailing Address - Phone:787-788-0833
Mailing Address - Fax:787-788-0833
Practice Address - Street 1:CALLE ISIDRA RODRIGUEZ
Practice Address - Street 2:6
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962
Practice Address - Country:US
Practice Address - Phone:787-788-0833
Practice Address - Fax:787-788-0833
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0823OtherFIRST MEDICAL
0823OtherFIRST MEDICAL