Provider Demographics
NPI:1982214250
Name:TOMEY-IMBERT, ANNETTE MARGARITA
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:MARGARITA
Last Name:TOMEY-IMBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 AVE ASHFORD STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1172
Mailing Address - Country:US
Mailing Address - Phone:787-531-6888
Mailing Address - Fax:
Practice Address - Street 1:1020 AVE ASHFORD STE 3
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1172
Practice Address - Country:US
Practice Address - Phone:787-531-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR472225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist