# CENTRO DE TERAPIA FISICA DE LARES, INC.

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

## Provider details

- **NPI number:** 1851399273
- **Authorized official:** MRS. NIZETTE I CORDERO RPT (PRESIDENT/PHYSICAL TERAPIST)
- **Authorized official phone:** (787) 898-5885

## Contact information

- **Practice address:** CARR. 129 KM. 13.6, BO. BAYANEY, HATILLO, PR 00659-0000
- **Practice address phone:** (787) 898-5885
- **Practice address fax:** (787) 898-5885
- **Mailing address:** REPARTO MARQUEZ, G-26 CALLE 9, ARECIBO, PR 00612-0000
- **Mailing address phone:** (787) 898-5885
- **Mailing address fax:** (787) 898-5885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 871 | PR | Yes |

## Other

- **Enumeration date:** 07/09/2005
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 238022 | PREFERRED HEALTH | PR |
| 01 | — | 3303349 | ACAA | PR |
| 01 | — | 3583548 | MMM | PR |
| 01 | — | 6400182 | HUMANA | PR |
| 01 | — | 89222 | TRIPLE-S | PR |
| 01 | — | 9004126 | CRUZ AZUL | PR |