Provider Demographics
NPI:1669717989
Name:PINO MUNOZ, ELIZABETH (RPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PINO MUNOZ
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EDIF INSTITUTO SAN PABLO
Mailing Address - Street 2:SUITE 301 #66 CALLE SANTA CRUZ
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7041
Mailing Address - Country:US
Mailing Address - Phone:787-740-2270
Mailing Address - Fax:787-785-7277
Practice Address - Street 1:EDIF INSTITUTO SAN PABLO
Practice Address - Street 2:SUITE 301 #66 CALLE SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7041
Practice Address - Country:US
Practice Address - Phone:787-740-2270
Practice Address - Fax:787-785-7277
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist