Provider Demographics
NPI:1518139930
Name:BERDASCO PAZ, MARIA DEL C (PT, MPH)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL C
Last Name:BERDASCO PAZ
Suffix:
Gender:F
Credentials:PT, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 QUINTAS LAS AMERICAS
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-7910
Mailing Address - Country:US
Mailing Address - Phone:787-312-1780
Mailing Address - Fax:
Practice Address - Street 1:149 QUINTAS LAS AMERICAS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7910
Practice Address - Country:US
Practice Address - Phone:787-312-1780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRQ-55310Medicare UPIN