Healthcare Provider Details

I. General information

NPI: 1174070718
Provider Name (Legal Business Name): ZAHIRA SOTELO-ACEVEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

P21 CALLE 8 URBANIZACION MEDINA
ISABELA PR
00662-3814
US

IV. Provider business mailing address

P21 CALLE 8 URB. MEDINA
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 787-313-2125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1266
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: