| Organization Name: | INSTITUTO FISIATRICO DE AIBONITO CSP |
| NPI Number: | 1194170175 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIE C LUGO (PRESIDENT) |
| Mailing Address: | 110 Calle Jose C Vazquez Frente Hospital Menonita Aibonito |
| State: | PR US |
| Postal Code: | 00705 |
| Phone Number: | 7877352445 |
| Fax Number: | 7879910885 |
| NPI Enumeration Date: | 04/27/2016 |
| NPI Last Update Date: | 04/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1800X |
| License Number: | 12266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Corporate Health |
| Taxonomy Definition: | |