Provider Demographics
NPI:1811202161
Name:CLINICA DE TERAPIA FISICA VILLA REAL INC
Entity Type:Organization
Organization Name:CLINICA DE TERAPIA FISICA VILLA REAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-644-4499
Mailing Address - Street 1:PO BOX 1423
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-1423
Mailing Address - Country:US
Mailing Address - Phone:787-654-8400
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 MARGINAL D18
Practice Address - Street 2:URB VILLA REAL
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-0000
Practice Address - Country:US
Practice Address - Phone:787-654-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy