Healthcare Provider Details

I. General information

NPI: 1174504799
Provider Name (Legal Business Name): MARCO AURELIO REMIGIO-RODRIGUEZ O.T.R.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MARCO AURELIO REMIGIO-RODRIGUEZ O.T.R.

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COND RIVER PARK PARK EDIF. D APART. #206
BAYAMON PR
00961-8500
US

IV. Provider business mailing address

COND RIVER PARK EDIF D APT #206
BAYAMON PR
00961-8500
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax: 787-641-5716
Mailing address:
  • Phone: 787-641-7582
  • Fax: 787-641-5716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number737
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: