MEDICARE: YELIZA QUINTANA BOSQUES OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	881	PR

General Provider Information

NPI Number	:	1790817542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YELIZA QUINTANA BOSQUES OT

Provider Business Mailing Address
First Line	:	PO BOX 360325
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-0325
Country	:	US
Telephone Number	:	787-244-1505
Fax Number	:	787-735-0380

Provider Business Practice Location Address
First Line	:	1274 AVENIDA HOSTOS
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00717
Country	:	US
Telephone Number	:	787-244-1505
Fax Number	:	787-735-0380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	03/05/2026

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