Provider Demographics
NPI:1831435288
Name:NEGRON MATOS, ARELYS J (MSPT)
Entity type:Individual
Prefix:
First Name:ARELYS
Middle Name:J
Last Name:NEGRON MATOS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 CALLE AGUACATE
Mailing Address - Street 2:URB. FOREST PLANTATION
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-9674
Mailing Address - Country:US
Mailing Address - Phone:787-348-9692
Mailing Address - Fax:
Practice Address - Street 1:216 CALLE PALMA REAL
Practice Address - Street 2:UNIVERSITY GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4801
Practice Address - Country:US
Practice Address - Phone:787-767-0266
Practice Address - Fax:787-767-0210
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist