# CENTRO DE MEDICINA FISICA Y REHABILITACION RIO GRANDE,INC

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

## Provider details

- **NPI number:** 1447226238
- **Authorized official:** ISAMARIS ORTIZ FUENTES (PRESIDENT)
- **Authorized official phone:** (787) 887-2555

## Contact information

- **Practice address:** B18 CALLE GARCIA DE LA NOCEDA, VILLAS DE RIO GRANDE, RIO GRANDE, PR 00745-0000
- **Practice address phone:** (787) 887-2555
- **Practice address fax:** (787) 657-5600
- **Mailing address:** PO BOX 2884, RIO GRANDE, PR 00745-2884
- **Mailing address phone:** (787) 887-2555
- **Mailing address fax:** (787) 657-5600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | PR | Yes |

## Other

- **Enumeration date:** 02/23/2006
- **Last updated:** 12/17/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 85426 | MEDICARE ID | PR |