Organization Active NPI

Rehabibilitacion Ponce de Leon Clinica de Terapia Fisica

  • Physical Therapist
  • Yauco, PR
National Provider Identifier
1417942640
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0731 Issued in PR
Legal business name
REHABIBILITACION PONCE DE LEON CLINICA DE TERAPIA FISICA
Practice address
42 Calle Mattei Lluberas
Suite 1
Yauco, PR 00698-3630
Phone
(787) 856-5272
Fax
(787) 856-8421
NPI assigned
Sep 14, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Edgardo Acosta Sr.
Title
Administrdor
Phone
(787) 856-5272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0731 PR Primary

Addresses

Primary practice location

42 Calle Mattei Lluberas
Suite 1
Yauco, PR 00698-3630

Mailing address

42 Calle Mattei Lluberas
Suite 1
Yauco, PR 00698-3630
Phone (787) 856-5272

Other identifiers 1

IdentifierTypeStateIssuer
0084104OtherPRTRIPLE S

National Provider Directory

National Provider Directory

Locations

42 Calle Mattei Lluberas
Ste 1
Yauco, PR 00698
Phone (787) 856-5272

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417942640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 CALLE MATTEI LLUBERAS",
            "address_2": "SUITE 1",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983630",
            "telephone_number": "787-856-5272",
            "fax_number": "787-856-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 CALLE MATTEI LLUBERAS",
            "address_2": "SUITE 1",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006983630",
            "telephone_number": "787-856-5272",
            "fax_number": "787-856-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABIBILITACION PONCE DE LEON CLINICA DE TERAPIA FISICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "EDGARDO",
        "authorized_official_title_or_position": "ADMINISTRDOR",
        "authorized_official_telephone_number": "787-856-5272",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "0731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "0084104",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yauco, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.