Provider Demographics
NPI:1902099278
Name:CENTRO FISIATRICO DR ANGEL COLON
Entity Type:Organization
Organization Name:CENTRO FISIATRICO DR ANGEL COLON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-878-4143
Mailing Address - Street 1:PO BOX 141299
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1299
Mailing Address - Country:US
Mailing Address - Phone:787-878-4143
Mailing Address - Fax:787-878-4143
Practice Address - Street 1:CARR 2 KM 8.1 MARGINAL REPARTO SAN MIGUEL
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-0000
Practice Address - Country:US
Practice Address - Phone:787-878-4143
Practice Address - Fax:787-878-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy