1023076288 NPI number — CENTRO DE TERAPIA FISICA Y CLINICA DEL DOLOR, CSP

Table of content: (NPI 1023076288)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023076288 NPI number — CENTRO DE TERAPIA FISICA Y CLINICA DEL DOLOR, CSP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO DE TERAPIA FISICA Y CLINICA DEL DOLOR, CSP
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:
1023076288
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 AVENIDA JF KENNEDY
Provider Second Line Business Mailing Address:
URBANIZACION FERNANDEZ
Provider Business Mailing Address City Name:
CIDRA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-714-0510
Provider Business Mailing Address Fax Number:
787-714-0185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 AVENIDA JF KENNEDY
Provider Second Line Business Practice Location Address:
URBANIZACION FERNANDEZ
Provider Business Practice Location Address City Name:
CIDRA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-714-0510
Provider Business Practice Location Address Fax Number:
787-714-0185
Provider Enumeration Date:
05/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ORELLANA
Authorized Official First Name:
ESPERANZA
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENTA ADMINISTRADORA
Authorized Official Telephone Number:
787-714-0510

Provider Taxonomy Codes

  • Taxonomy code: 225200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 223205 . This is a "PREFERRED UTI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6400208 . This is a "HUMANA REFORMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 870044 . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04232 . This is a "AMERICAN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 79809 . This is a "CFSE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 584576598 . This is a "GIGNA PREFERRED EXCLUSIVE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4177 . This is a "FIRST MEDICAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60565208 . This is a "FIRST PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: M000409 . This is a "MEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6400208 . This is a "HUMANA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3303543 . This is a "ACAA" identifier . This identifiers is of the category "OTHER".