Sergio Bogoljubskij
Individual provider Active NPI Mechanotherapist · San Juan, PR
NPI 1386953446 · NPPES record last updated Oct 6, 2010
Key facts
- NPI
- 1386953446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mechanotherapist 172M00000X
- License
- 7046 (MS)
- Practice address
- 111 Marginal Ave FD Roosevelt
6 A Cond Escorial
San Juan, PR 00917-2736 - Phone
- (787) 318-4442
- NPI assigned
- Oct 6, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7046 | MS | MD | Mechanotherapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SB Systems LLC | Mechanotherapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 7046 | MS | Yes |
Addresses
Primary practice location
111 Marginal Ave FD Roosevelt
6 A Cond Escorial
San Juan, PR 00917-2736
Mailing address
111 Roosevelt Avenue
Cond Escorial Apt 6 a
San Juan, PR 00917-2714
Phone (787) 318-4442
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- Cynthia Bojito
- Orlando Bolet
- Laura Mercedes Bolorin Vargas
- Fernando Bonafoux
- Keisy Bonano Baez
All providers in San Juan, PR · Mechanotherapist in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.