Individual
RENE RIVERA COLLAZO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
SANTA ROSA MALL, SUITE 218, BAYAMON, PR 00961
(787) 798-3967
(787) 269-5686
Mailing address
21 CALLE HECTOR PANTOJAS, VEGA BAJA, PR 00693-4031
(787) 515-0038
(787) 269-5686
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4584
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4584
LICENCIA
PR
Enumeration date
11/08/2021
Last updated
11/10/2021
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