Healthcare Provider Details

I. General information

NPI: 1972218048
Provider Name (Legal Business Name): YAMILIZ ORTEGA-ROSA OCCUPATIONAL THERAPI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIF 3 APT 110 ISLABELA BEACH RESORT
ISABELA PR
00662
US

IV. Provider business mailing address

EDIF 3 APT 110 ISLABELA BEACH RESORT
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 787-594-9856
  • Fax:
Mailing address:
  • Phone: 787-594-9856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1099
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: