Provider Demographics
NPI:1639141302
Name:FISIOTERAPIA EN LA MONTANA
Entity Type:Organization
Organization Name:FISIOTERAPIA EN LA MONTANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADORNO
Authorized Official - Suffix:
Authorized Official - Credentials:MSS, PT
Authorized Official - Phone:787-884-8923
Mailing Address - Street 1:PO BOX 1854
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-1854
Mailing Address - Country:US
Mailing Address - Phone:787-884-8923
Mailing Address - Fax:787-884-8923
Practice Address - Street 1:AVE. ELLIOT VELEZ
Practice Address - Street 2:J-20
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-1854
Practice Address - Country:US
Practice Address - Phone:787-884-8923
Practice Address - Fax:787-884-8923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1122251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
84769Medicare ID - Type Unspecified
83554Medicare ID - Type Unspecified