# CENTRO DE REHABILITACION Y ELECTRODIAGNOSTICO DE HATO REY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013009984
- **Authorized official:** DR. MIGUEL P CARDONA M.D. (OWNER)
- **Authorized official phone:** (787) 754-0725

## Contact information

- **Practice address:** 419 PONCE DE LEON, EDIFICIO METROPOLIS SUITE 102, SAN JUAN, PR 00917-3403
- **Practice address phone:** (787) 754-0725
- **Practice address fax:** (787) 622-3490
- **Mailing address:** 419 PONCE DE LEON, EDIFICIO METROPOLIS SUITE 102, SAN JUAN, PR 00917-3403
- **Mailing address phone:** (787) 754-0725
- **Mailing address fax:** (787) 622-3490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | 9491 | PR | — |

## Other

- **Enumeration date:** 09/29/2006
- **Last updated:** 12/23/2024