Provider Demographics
NPI:1972938199
Name:PUERTO RICO THERAPY GROUP, INC
Entity Type:Organization
Organization Name:PUERTO RICO THERAPY GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAZEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-331-0129
Mailing Address - Street 1:AVE PONCE DE LEON # 416
Mailing Address - Street 2:UNIT 801
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1000
Mailing Address - Country:US
Mailing Address - Phone:787-331-0129
Mailing Address - Fax:
Practice Address - Street 1:AVE PONCE DE LEON # 416
Practice Address - Street 2:UNIT 801
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1000
Practice Address - Country:US
Practice Address - Phone:787-331-0129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization