Provider Demographics
NPI:1871979815
Name:CENTRO DE TERAPIA FISICA DE SANTA ROSA
Entity type:Organization
Organization Name:CENTRO DE TERAPIA FISICA DE SANTA ROSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATAOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:AYBAR-OTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-780-5910
Mailing Address - Street 1:PO BOX 383
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0383
Mailing Address - Country:US
Mailing Address - Phone:787-780-5910
Mailing Address - Fax:
Practice Address - Street 1:10-2 AVE AGUAS BUENAS
Practice Address - Street 2:URB. SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6611
Practice Address - Country:US
Practice Address - Phone:787-780-5910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy