Healthcare Provider Details
I. General information
NPI: 1245096254
Provider Name (Legal Business Name): ACUARELA THERAPY CENTER CORP.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2024
Last Update Date: 02/27/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARR 2 KM 57.2 BO. FLORIDA AFUERA
BARCELONETA PR
00617
US
IV. Provider business mailing address
N2 CALLE D
VEGA BAJA PR
00693-4036
US
V. Phone/Fax
- Phone: 939-451-8696
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
JENILEE
SOLER JIMENEZ
Title or Position: PRESIDENT
Credential: ADMINISTRATOR
Phone: 939-451-8696