Healthcare Provider Details

I. General information

NPI: 1457541211
Provider Name (Legal Business Name): XIOMARA ROSARIO TORRES TO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CRECIENDO JUNTOS, INC BARRIO PALENQUE 90 A
BARCELONETA PR
00617
US

IV. Provider business mailing address

19 BO SABANA SECA
MANATI PR
00674-6621
US

V. Phone/Fax

Practice location:
  • Phone: 787-623-2869
  • Fax:
Mailing address:
  • Phone: 787-396-0530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1040
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: