Provider Demographics
NPI:1801862594
Name:CLINICA DE TERAPIA FISICA INC
Entity Type:Organization
Organization Name:CLINICA DE TERAPIA FISICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:E
Authorized Official - Last Name:DIEPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-756-5685
Mailing Address - Street 1:PO BOX 192767
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2767
Mailing Address - Country:US
Mailing Address - Phone:787-756-5685
Mailing Address - Fax:787-763-7833
Practice Address - Street 1:271 DOMENECH ST.
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-756-5685
Practice Address - Fax:787-763-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty