Healthcare Provider Details

I. General information

NPI: 1265308233
Provider Name (Legal Business Name): CLINICA DE TERAPIAS PEDIATRICAS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. VILLA BLANCA CALLE AQUAMARINA #66
CAGUAS PR
00725-1908
US

IV. Provider business mailing address

URB. VILLA BLANCA CALLE AQUAMARINA #66
CAGUAS PR
00725-1908
US

V. Phone/Fax

Practice location:
  • Phone: 787-743-3941
  • Fax:
Mailing address:
  • Phone: 787-743-3941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224ZF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. RAMON LUIS RIVERA
Title or Position: GERENTE DE FINANZAS
Credential:
Phone: 787-239-7761