Provider Demographics
NPI:1558411884
Name:CLINICA DE MEDICINA FISICA Y ELECTRODIAGNOSTICO INC.
Entity Type:Organization
Organization Name:CLINICA DE MEDICINA FISICA Y ELECTRODIAGNOSTICO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:I
Authorized Official - Credentials:MBA
Authorized Official - Phone:787-891-4833
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-0009
Mailing Address - Country:US
Mailing Address - Phone:787-891-4833
Mailing Address - Fax:787-882-5405
Practice Address - Street 1:AVE. KENNEDY INT. 107
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-4833
Practice Address - Fax:787-882-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy