1508426115 NPI number — SENIOR PHYSICAL THERAPY OF PR, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508426115 NPI number — SENIOR PHYSICAL THERAPY OF PR, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENIOR PHYSICAL THERAPY OF PR, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508426115
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
354 VIA SANTA CATALINA COND ALTOS REALES
Provider Second Line Business Mailing Address:
APT 914
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-810-3853
Provider Business Mailing Address Fax Number:
787-993-6030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
B1 CALLE 6
Provider Second Line Business Practice Location Address:
MANSIONES DE GARDEN HILLS
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-810-3853
Provider Business Practice Location Address Fax Number:
787-993-6030
Provider Enumeration Date:
06/17/2019

Additional Information

Authorized Official

Authorized Official Last Name:
PAGE
Authorized Official First Name:
AYMEE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-810-3853

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com