Provider Demographics
NPI:1740920149
Name:CASAL BORGES, VERONICA SOFIA
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:SOFIA
Last Name:CASAL BORGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 CALLE HOOVER
Mailing Address - Street 2:PASEO CARIBE BUILDING STE. 104
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-218-2132
Mailing Address - Fax:
Practice Address - Street 1:15 MUNOZ RIVERA AVE
Practice Address - Street 2:PASEO CARIBE BUILDING STE. 104
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-0090
Practice Address - Country:US
Practice Address - Phone:888-900-0073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6108822OtherLIC