Basic Information
| Provider Information | |||||||||
| NPI: | 1083016638 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CRUZ & MENA PHYSICAL THERAPY INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6018 | ||||||||
| Address2: | |||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006816018 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 59 MARTINEZ NADAL | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878344090 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2014 | ||||||||
| LastUpdateDate: | 09/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | MENA-GONZALEZ | ||||||||
| AuthorizedOfficialFirstName: | NERIE | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7878344090 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.