# BALANCE AND VESTIBULAR REHAB, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1255788386
- **Authorized official:** DR. ELIMARIS FUENTES DPT (PRESIDENT)
- **Authorized official phone:** (787) 552-9757

## Contact information

- **Practice address:** CARR. 8860 KM 1.5, PLAZA MATIENZO, TRUJILLO ALTO, PR 00976-6426
- **Practice address phone:** (787) 552-9757
- **Mailing address:** L26 CALLE 14, EL CONQUISTADOR, TRUJILLO ALTO, PR 00976-6426
- **Mailing address phone:** (787) 552-9757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 1431 | PR | Yes |

## Other

- **Enumeration date:** 05/18/2016
- **Last updated:** 08/03/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 511526117516-001 | CCN MEDICARE | PR |