Provider Demographics
NPI:1376714576
Name:CLINICA TERAPEUTICA ATLETICA LOAVI
Entity Type:Organization
Organization Name:CLINICA TERAPEUTICA ATLETICA LOAVI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:787-825-3019
Mailing Address - Street 1:8 CALLE BARBOSA
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-3266
Mailing Address - Country:US
Mailing Address - Phone:787-825-3019
Mailing Address - Fax:787-803-2302
Practice Address - Street 1:8 CALLE BARBOSA
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-3266
Practice Address - Country:US
Practice Address - Phone:787-825-3019
Practice Address - Fax:787-803-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7344OtherINT. MEDICAL CARD