Provider Demographics
NPI:1467445585
Name:CENTRO DE TERAPIA FISICA DEL NORESTE INC
Entity Type:Organization
Organization Name:CENTRO DE TERAPIA FISICA DEL NORESTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-876-0250
Mailing Address - Street 1:972 CALLE BAUHINIA
Mailing Address - Street 2:LOIZA VALLEY
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-3410
Mailing Address - Country:US
Mailing Address - Phone:787-876-0250
Mailing Address - Fax:
Practice Address - Street 1:972 CALLE BAUHINIA
Practice Address - Street 2:LOIZA VALLEY
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-3410
Practice Address - Country:US
Practice Address - Phone:787-876-0250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy