Healthcare Provider Details

I. General information

NPI: 1437114915
Provider Name (Legal Business Name): CRISTIAN DAVID PRADO MOTRL, DPT, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CRISTIAN D PRADO CAPETILLO MOTRL, DPT

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 AVENIDA PONCE DE LEON TORRE AUXILIO MUTUO
SAN JUAN PR
00917-5029
US

IV. Provider business mailing address

CALLE GAVIOTA FF-8
DORADO PR
00646-2309
US

V. Phone/Fax

Practice location:
  • Phone: 904-315-0394
  • Fax: 888-796-2874
Mailing address:
  • Phone: 904-315-0394
  • Fax: 888-796-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4548
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT26351
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT12243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: