Healthcare Provider Details

I. General information

NPI: 1740336585
Provider Name (Legal Business Name): ILIANA RODRIGUEZ ANDINO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 1490 KM 0.6 BO. MONACILLO
GUAYNABO PR
00966
US

IV. Provider business mailing address

PO BOX 2124
SAN JUAN PR
00922-2124
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-2226
  • Fax:
Mailing address:
  • Phone: 787-783-2226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number787
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: