Provider Demographics
NPI:1750441556
Name:TORT, AIXA AIMEE (PT)
Entity type:Individual
Prefix:MS
First Name:AIXA
Middle Name:AIMEE
Last Name:TORT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 CALLE THEIS
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3200
Mailing Address - Country:US
Mailing Address - Phone:787-602-0686
Mailing Address - Fax:787-294-1265
Practice Address - Street 1:1733 CALLE THEIS
Practice Address - Street 2:RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3248
Practice Address - Country:US
Practice Address - Phone:787-692-3646
Practice Address - Fax:787-294-1265
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1317261QP2000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy