Eduardo Jose Correa Vazquez, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004588 Issued in PR

Practice address

Urb. Condado Moderno Ave Munoz Marin
M-13
Caguas, PR 00725

Phone

(787) 745-4355

NPI assigned

Jan 29, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1104417492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 AVE ARTERIAL HOSTOS APT 230",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183052",
            "telephone_number": "787-648-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. CONDADO MODERNO AVE MUNOZ MARIN",
            "address_2": "M-13",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-745-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA VAZQUEZ",
        "first_name": "EDUARDO",
        "middle_name": "JOSE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "004588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corporacion de Salud Asegurada Por Nuestra Organizacion Solidaria, Inc
• Corporacion de Salud Asegurada Por Nuestra Organizacion Solidaria, Inc
• Corporacion Renace Creyendo En Ti
• Pedro Luis Correa Amil, OD
• Christian Gerardo Correa Garcia
• Luis R Correa-Jimenez, MD
• Clarissa Maria Correa
• Erika Correa
• Felipe E. Correa, DMD
• Javier Rafael Correa, MD

• Physical Therapist in Caguas, PR
• Providers in Caguas, PR by specialty
• Physical Therapist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.