Irismar Diaz

Individual provider Active NPI Physical Therapy Assistant · Patillas, PR

NPI 1760596332 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1760596332
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1718 (PR)
Practice address
Car. 799 KM 0 HM 8 Bo. Cacao Bajo
Patillas, PR 00723
Phone
(787) 237-6526
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

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
1718PRMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1718 PR Yes

Addresses

Primary practice location

Car. 799 KM 0 HM 8 Bo. Cacao Bajo
Patillas, PR 00723

Mailing address

Car. 799 KM 0 HM 8 Bo. Cacao Bajo
Patillas, PR 00723
Phone (787) 237-6526

Other providers in Patillas, PR

All providers in Patillas, PR · Physical Therapy Assistant in Puerto Rico

Sources for this page

Verify at the official NPI Registry.