Provider Demographics
NPI:1538596994
Name:MAXIMAL THERAPY GROUP, P S C
Entity type:Organization
Organization Name:MAXIMAL THERAPY GROUP, P S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORALES GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-261-5093
Mailing Address - Street 1:90 AVENUE RIO HONDO
Mailing Address - Street 2:PMB 454
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3105
Mailing Address - Country:US
Mailing Address - Phone:787-261-5093
Mailing Address - Fax:787-784-9264
Practice Address - Street 1:AVENIDA DOS PALMAS #2826
Practice Address - Street 2:2DA SECCION LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-261-5093
Practice Address - Fax:787-784-9264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy