Provider Demographics
NPI:1477187284
Name:PIZARRO BATISTA, NILDA L (RPT)
Entity type:Individual
Prefix:
First Name:NILDA
Middle Name:L
Last Name:PIZARRO BATISTA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TORRE MEDICA SAN LUCAS
Mailing Address - Street 2:909 TITO CASTRO AVE. SUITE 621
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-290-4466
Mailing Address - Fax:787-290-8866
Practice Address - Street 1:TORRE MEDICA SAN LUCAS
Practice Address - Street 2:909 TITO CASTRO AVE. SUITE 621
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-290-4466
Practice Address - Fax:787-290-8866
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist