Provider Demographics
NPI:1447078605
Name:THERAPRO
Entity type:Organization
Organization Name:THERAPRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTORADO EN TERAPUA FISICA
Authorized Official - Prefix:
Authorized Official - First Name:DENIEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:RIVERA MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:787-467-7459
Mailing Address - Street 1:475 CARR 8860 # APP2386
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-5401
Mailing Address - Country:US
Mailing Address - Phone:787-467-7459
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 735 KM 0.5
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-467-7459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1679180806OtherTERAPISTA OCUPACIONAL