Healthcare Provider Details

I. General information

NPI: 1982988457
Provider Name (Legal Business Name): ARCILIA RIVERA-JIMENEZ MS, OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27-16 AVE ROBERTO CLEMENTE URB. VILLA CAROLINA
CAROLINA PR
00985-5420
US

IV. Provider business mailing address

1090 CALLE TOPACIO
BARCELONETA PR
00617-2951
US

V. Phone/Fax

Practice location:
  • Phone: 787-276-8123
  • Fax:
Mailing address:
  • Phone: 787-787-3233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number737-1
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1132
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: