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Organization

REHABILITACION DORADA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. XANDRA N ZAYAS-CRESPO RPT (RPT- PRESIDENT)
(939) 630-2569
Entity
Organization

Contact information

Practice address
URB GRAN VISTA 1 CAMINO DEL PLATA, TOA ALTA, PR 00953
(939) 630-2569
(787) 870-6706
Mailing address
URB GRAN VISTA 1 CAMINO DEL PLATA, TOA ALTA, PR 00953
(939) 630-2569
(787) 870-6706

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1375
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038231100
PR
01
1375
STATE LICENCE
PR
01
1508061037
INDIVIDUAL NPI
PR
Enumeration date
04/25/2012
Last updated
04/27/2022
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