Provider Demographics
NPI:1720300171
Name:CENTRO DE TERAPIA FISICA GREEN HILLS, PSC
Entity Type:Organization
Organization Name:CENTRO DE TERAPIA FISICA GREEN HILLS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-235-4456
Mailing Address - Street 1:PO BOX 1380
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-864-0445
Mailing Address - Fax:787-864-0511
Practice Address - Street 1:CARRETERA ESTATAL PR 54, INT. PR #3
Practice Address - Street 2:COMMERCE PLAZA. LOCAL 101-C
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-864-0445
Practice Address - Fax:787-864-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
612261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy