# BOULEVARD HEALTH CARE PROGRAM

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

## Provider details

- **NPI number:** 1750445292
- **Authorized official:** MRS. LUISA GONZALEZ ROMAN (PHYSICAL THERAPIST)
- **Authorized official phone:** (787) 784-0148

## Contact information

- **Practice address:** URB LEVITTOWN, P1449 AVE. BOULEVARD, TOA BAJA, PR 00949
- **Practice address phone:** (787) 784-0148
- **Mailing address:** PO BOX 8492, BAYAMON, PR 00960-8492
- **Mailing address phone:** (787) 784-0148
- **Mailing address fax:** (787) 784-0148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 414 | PR | Yes |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/22/2020