Healthcare Provider Details

I. General information

NPI: 1265246490
Provider Name (Legal Business Name): NICOLE MARIE SUAZO-VALDEZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDOMINIO PORTALES DE ALHELI 2050 CARR 8177 APT 505
GUAYNABO PR
00966-3757
US

IV. Provider business mailing address

CONDOMINIO PORTALES DE ALHELI 2050 CARR 8177 APT 505
GUAYNABO PR
00966-3757
US

V. Phone/Fax

Practice location:
  • Phone: 787-484-8492
  • Fax:
Mailing address:
  • Phone: 787-484-8492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1332
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: