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NPI Code Detail

MEDICARE: MARITZA CORDERO GONZALEZ OTR/L

MEDICARE: MARITZA CORDERO GONZALEZ OTR/L
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
1225X00000XOccupational Therapist0987PR

General Provider Information

NPI Number : 1972816643
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARITZA CORDERO GONZALEZ OTR/L
Provider Business Mailing Address
First Line : HC 7 BOX 76350
Second Line :
City : SAN SEBASTIAN
State : PR
Zip : 00685-7366
Country : US
Telephone Number : 787-464-0810
Fax Number :
Provider Business Practice Location Address
First Line : 66 CALLE MJ CABRERO
Second Line :
City : SAN SEBASTIAN
State : PR
Zip : 00685-4843
Country : US
Telephone Number : 787-955-0270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2010
Last Update Date : 09/10/2024

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