Provider Demographics
NPI:1538647862
Name:CLINICA TERAPEUTICA NERI
Entity Type:Organization
Organization Name:CLINICA TERAPEUTICA NERI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:GONZALEZ TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-645-5066
Mailing Address - Street 1:7000 CARR 844 BOX 50
Mailing Address - Street 2:ESTANCIAS DE BOULEVARD
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-645-5066
Mailing Address - Fax:
Practice Address - Street 1:103 CALLE BARCELO
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794-1605
Practice Address - Country:US
Practice Address - Phone:787-645-5066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR225X00000X
PR534235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR534OtherLICENSE