Provider Demographics
NPI:1023142098
Name:CARIBBEAN MEDICAL AND REHAB CORP
Entity type:Organization
Organization Name:CARIBBEAN MEDICAL AND REHAB CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLOUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-484-4937
Mailing Address - Street 1:2225 PONCE BYP STE 301
Mailing Address - Street 2:EDIFICIO PARRA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1322
Mailing Address - Country:US
Mailing Address - Phone:787-848-4937
Mailing Address - Fax:
Practice Address - Street 1:2225 PONCE BYP STE 301
Practice Address - Street 2:EDIFICIO PARRA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1322
Practice Address - Country:US
Practice Address - Phone:787-848-4937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7910034OtherHUMANA
PR7910034OtherHUMANA