Provider Demographics
NPI:1871293316
Name:SARRAGA, ALBERTO SR (DPT)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:SARRAGA
Suffix:SR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 CALLE BASALTO
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-8546
Mailing Address - Country:US
Mailing Address - Phone:787-972-3826
Mailing Address - Fax:
Practice Address - Street 1:249 CALLE BASALTO
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-8546
Practice Address - Country:US
Practice Address - Phone:787-972-3826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1418225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4453520OtherDRIVERS LICENSE