MEDICARE: MRS. ALICIA RAMIREZ OTL

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	442	PR

General Provider Information

NPI Number	:	1861514267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA RAMIREZ OTL

Provider Business Mailing Address
First Line	:	MB106 PASEO DEL CAMPO
Second Line	:	PARQUE DEL MONTE
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976-6090
Country	:	US
Telephone Number	:	787-283-8608
Fax Number	:

Provider Business Practice Location Address
First Line	:	MB106 PASEO DEL CAMPO
Second Line	:	PARQUE DEL MONTE
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976-6090
Country	:	US
Telephone Number	:	787-283-8608
Fax Number	:

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	07/08/2007

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