Provider Demographics
NPI:1982681565
Name:SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.
Entity Type:Organization
Organization Name:SERVICIOS INTEGRADOS DE REHABILITACION DEL OESTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-849-2179
Mailing Address - Street 1:PO BOX 1302
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-5302
Mailing Address - Country:US
Mailing Address - Phone:787-849-2179
Mailing Address - Fax:787-849-2205
Practice Address - Street 1:STREET 4 HOUSE L-10
Practice Address - Street 2:COLINAS DEL OESTE
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-849-2179
Practice Address - Fax:787-849-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR33-03837OtherACAA
PR7285934OtherCIGNA
PR223153OtherPREFERRED HEALTH PLAN
PR3228-5OtherAMPR
PR00432OtherAMERICAN HEALTH PLAN
PR6600020OtherHUMANA AMB
PR7951OtherIMC/AMB
PR=========OtherMCS
PR3228-5OtherAMPR
PR=========OtherCOSVI
PR00432OtherAMERICAN HEALTH PLAN
PR017-=========OtherGLOBAL HEALTH
PR3228-5OtherAMPR