Healthcare Provider Details

I. General information

NPI: 1437086949
Provider Name (Legal Business Name): LUIS OSCAR ALBALADEJO COLON OTL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 5 BOX 5454
TOA ALTA PR
00953-8941
US

IV. Provider business mailing address

RR 5 BOX 5454
TOA ALTA PR
00953-8941
US

V. Phone/Fax

Practice location:
  • Phone: 787-612-5079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1406
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: