Healthcare Provider Details

I. General information

NPI: 1174446868
Provider Name (Legal Business Name): KATIRIA PEREZ CABAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 AVE LAS PALMAS
MANATI PR
00674-4958
US

IV. Provider business mailing address

201 AVE LAS PALMAS
MANATI PR
00674-4958
US

V. Phone/Fax

Practice location:
  • Phone: 939-323-8073
  • Fax:
Mailing address:
  • Phone: 939-323-8073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2421
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: