Healthcare Provider Details

I. General information

NPI: 1780472555
Provider Name (Legal Business Name): MRS. ANGELY MICHELLE ESPINOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA SOL DE BORINQUEN 139 CALLE VILLA
PONCE PR
00730
US

IV. Provider business mailing address

URB. ESTANCIAS DEL GOLF 545
PONCE PR
00730
US

V. Phone/Fax

Practice location:
  • Phone: 787-690-2732
  • Fax:
Mailing address:
  • Phone: 787-690-2732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1351
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: