Provider Demographics
NPI:1134361447
Name:CENTRO DE REHABILITACION TERAPIA EN ACCION
Entity type:Organization
Organization Name:CENTRO DE REHABILITACION TERAPIA EN ACCION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ENNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MSG
Authorized Official - Phone:787-460-4632
Mailing Address - Street 1:HC 2 BOX 13187
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-9688
Mailing Address - Country:US
Mailing Address - Phone:787-732-7512
Mailing Address - Fax:787-732-7512
Practice Address - Street 1:CARR 156 RAMAL 794 INT KM 1.2
Practice Address - Street 2:BO SUMIDERO SECTOR LA ARANA
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703-9688
Practice Address - Country:US
Practice Address - Phone:787-732-7512
Practice Address - Fax:787-732-7512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR797225X00000X
PR000249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty