Provider Demographics
NPI:1922862705
Name:GRUPO FISIATRICO DE COROZAL PSC
Entity Type:Organization
Organization Name:GRUPO FISIATRICO DE COROZAL PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ARIAS BENABE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-859-8726
Mailing Address - Street 1:PO BOX 2760
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2760
Mailing Address - Country:US
Mailing Address - Phone:787-859-8726
Mailing Address - Fax:787-859-8729
Practice Address - Street 1:7 CALLE BOU
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2017
Practice Address - Country:US
Practice Address - Phone:787-859-8726
Practice Address - Fax:787-859-8729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty