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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7046MSMDMechanotherapist

Practice roles

OrganizationSpecialtyStatusNew patients
SB Systems LLC Mechanotherapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in San Juan, PR

All providers in San Juan, PR · Mechanotherapist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.