Provider Demographics
NPI:1356708598
Name:TERAPIAS LA MONSERRATE,INC
Entity type:Organization
Organization Name:TERAPIAS LA MONSERRATE,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILKINS
Authorized Official - Middle Name:
Authorized Official - Last Name:FELICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:787-873-5999
Mailing Address - Street 1:100 AVE 5 DE DICIEMBRE
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1961
Mailing Address - Country:US
Mailing Address - Phone:787-873-5999
Mailing Address - Fax:
Practice Address - Street 1:100 AVE 5 DE DICIEMBRE
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1961
Practice Address - Country:US
Practice Address - Phone:787-873-5999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)