Provider Demographics
NPI:1952501116
Name:TROCHE-MONTES, LOURDES (MSPT)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:TROCHE-MONTES
Suffix:
Gender:F
Credentials:MSPT
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 239
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0239
Mailing Address - Country:US
Mailing Address - Phone:787-963-2527
Mailing Address - Fax:787-281-8144
Practice Address - Street 1:576 CALLE CESAR GONZALEZ
Practice Address - Street 2:502 STE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3756
Practice Address - Country:US
Practice Address - Phone:787-771-2391
Practice Address - Fax:787-281-8144
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1358261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy