Provider Demographics
NPI:1841288198
Name:GRUPO FISIATRICO DE COROZAL
Entity type:Organization
Organization Name:GRUPO FISIATRICO DE COROZAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISIATRA
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:ARIAS BENABE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-859-8726
Mailing Address - Street 1:PO BOX 2760
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2760
Mailing Address - Country:US
Mailing Address - Phone:787-859-8726
Mailing Address - Fax:787-859-8724
Practice Address - Street 1:7 CALLE BOU
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-1949
Practice Address - Country:US
Practice Address - Phone:787-859-8726
Practice Address - Fax:787-859-8724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty