Provider Demographics
NPI:1811074958
Name:TERAPIA FISICA ELMAR INC.
Entity type:Organization
Organization Name:TERAPIA FISICA ELMAR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VENDRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-224-4185
Mailing Address - Street 1:PO BOX 144036
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4036
Mailing Address - Country:US
Mailing Address - Phone:787-975-7441
Mailing Address - Fax:787-881-5572
Practice Address - Street 1:CAR 2 KM 62.8 SECTOR CANDELARIA
Practice Address - Street 2:BO SABANA HOYOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-975-7441
Practice Address - Fax:787-881-5572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR153107261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1811074958OtherTHERAPY NETWORK PUERTO RICO
PRB050OtherINTERNATIONAL MEDICAL CARD
PRB050OtherINTERNATIONAL MEDICAL CARD
PR1811074958OtherTHERAPY NETWORK PUERTO RICO
PR=========OtherAMERICAN HEALTH MEDICARE
PR=========OtherAMERICAN HEALTH MEDICARE