1992832612 NPI number — MEDICINA FISICA Y REHABILITACION DEL NORTE, 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 1992832612 NPI number — MEDICINA FISICA Y REHABILITACION DEL NORTE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICINA FISICA Y REHABILITACION DEL NORTE, 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:
1992832612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 141089
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARECIBO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00614-1089
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-817-0250
Provider Business Mailing Address Fax Number:
787-817-0250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CONDOMINIO ARECIBO MEDICAL CENTER
Provider Second Line Business Practice Location Address:
OFICINA 106 PRIMER PISO
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-880-7411
Provider Business Practice Location Address Fax Number:
787-817-0250
Provider Enumeration Date:
02/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VALENTIN MARRERO
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
N
Authorized Official Title or Position:
FISIATRA
Authorized Official Telephone Number:
787-817-0250

Provider Taxonomy Codes

  • Taxonomy code: 261QR0401X , with the licence number:  6528 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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