Healthcare Provider Details

I. General information

NPI: 1134040322
Provider Name (Legal Business Name): GABRIELA NICOLE OTERO ATO/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9VVV VC3, AV. LUIS VIGOREAUX
SAN JUAN PR
00966-6235
US

IV. Provider business mailing address

COND QUINTAS DE CUPEY APT C102
SAN JUAN PR
00926-6235
US

V. Phone/Fax

Practice location:
  • Phone: 939-397-8551
  • Fax:
Mailing address:
  • Phone: 939-397-8551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number1625
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: