Provider Demographics
NPI:1952791659
Name:JOSE GUILLERMO AMY PM&R LLC
Entity Type:Organization
Organization Name:JOSE GUILLERMO AMY PM&R LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:GUILLERMO
Authorized Official - Last Name:AMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-798-3967
Mailing Address - Street 1:E22 CALLE SANTA CRUZ
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6905
Mailing Address - Country:US
Mailing Address - Phone:787-798-3967
Mailing Address - Fax:
Practice Address - Street 1:E22 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6905
Practice Address - Country:US
Practice Address - Phone:787-798-3967
Practice Address - Fax:787-269-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR131182251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty