Centro de Terapia Fisica Y Atletica Nueva Vida PSC

Organization Active NPI Physical Therapist · Hatillo, PR

NPI 1194048967 · NPPES record last updated May 15, 2015

Key facts

NPI
1194048967
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
CENTRO DE TERAPIA FISICA Y ATLETICA NUEVA VIDA PSC
Practice address
462 Atlantic View Buildin Suite 2
Carretera 2 KM 83.5 Marginal Carrizales
Hatillo, PR 00659-0000
Phone
(787) 544-6888
Fax
(787) 544-6888
NPI assigned
Mar 9, 2010
Organization subpart
No

Authorized official

Name
Ivelisse Millet Santiago, MSPT
Title
Owner
Phone
(787) 544-6888

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20101004001217 PR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7517159932 Receives reassigned benefits from 1 practitioner
Practice locations: Arecibo, PR; Hatillo, PR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X Yes

Addresses

Primary practice location

462 Atlantic View Buildin Suite 2
Carretera 2 KM 83.5 Marginal Carrizales
Hatillo, PR 00659-0000

Mailing address

PO Box 141024
Arecibo, PR 00614-1024
Phone (787) 544-6888

Other providers in Hatillo, PR

All providers in Hatillo, PR · Physical Therapist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.