Provider Demographics
NPI:1417147729
Name:ACTIVO Y EN MOVIMIENTO TERAPIA FISICA Y OCUPACIONAL
Entity Type:Organization
Organization Name:ACTIVO Y EN MOVIMIENTO TERAPIA FISICA Y OCUPACIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:ORTIZ
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MPT,PT
Authorized Official - Phone:787-849-3884
Mailing Address - Street 1:CALLE GERANIO 491 HACIENDA FLORIDA
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-4536
Mailing Address - Country:US
Mailing Address - Phone:787-849-3884
Mailing Address - Fax:787-849-3884
Practice Address - Street 1:491 CALLE GERANIO
Practice Address - Street 2:HACIENDA FLORIDA
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-4536
Practice Address - Country:US
Practice Address - Phone:787-849-3884
Practice Address - Fax:787-849-3884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1068261QP2000X
PR1033261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine