Provider Demographics
NPI:1992832612
Name:MEDICINA FISICA Y REHABILITACION DEL NORTE, INC.
Entity Type:Organization
Organization Name:MEDICINA FISICA Y REHABILITACION DEL NORTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISIATRA
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:VALENTIN MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-817-0250
Mailing Address - Street 1:PO BOX 141089
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1089
Mailing Address - Country:US
Mailing Address - Phone:787-817-0250
Mailing Address - Fax:787-817-0250
Practice Address - Street 1:CONDOMINIO ARECIBO MEDICAL CENTER
Practice Address - Street 2:OFICINA 106 PRIMER PISO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-880-7411
Practice Address - Fax:787-817-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6528261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)