Provider Demographics
NPI:1801187554
Name:ROBLES PEREZ, CYNTHIA ODALY
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:ODALY
Last Name:ROBLES PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2027
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-2027
Mailing Address - Country:US
Mailing Address - Phone:787-617-2984
Mailing Address - Fax:787-889-5030
Practice Address - Street 1:VISTAS DE LUQUILLO 2
Practice Address - Street 2:CALLE ZAFIRO 621
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773-2684
Practice Address - Country:US
Practice Address - Phone:787-617-2984
Practice Address - Fax:787-889-5030
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist