Provider Demographics
NPI:1275672784
Name:CENTRO DE TERAPIA FISICA PEDIATRICA
Entity Type:Organization
Organization Name:CENTRO DE TERAPIA FISICA PEDIATRICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIREYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:939-645-7887
Mailing Address - Street 1:467 CALLE REINA DE LAS FLORES
Mailing Address - Street 2:HACIENDA REAL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-9787
Mailing Address - Country:US
Mailing Address - Phone:939-645-7887
Mailing Address - Fax:787-769-3252
Practice Address - Street 1:CARRETERA 857 KILOMETRO 0.4
Practice Address - Street 2:CANOVANILLA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:939-645-7887
Practice Address - Fax:787-769-3252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1146174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========1OtherMCS