Healthcare Provider Details

I. General information

NPI: 1255122834
Provider Name (Legal Business Name): SONIA NOEMI CUADRADO OTL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PMB-75 RR-11 BOX 5829
BAYAMON PR
00956
US

IV. Provider business mailing address

PMB-75 RR-11 BOX 5829
BAYAMON PR
00956
US

V. Phone/Fax

Practice location:
  • Phone: 787-473-8631
  • Fax:
Mailing address:
  • Phone: 787-473-8631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number734
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: