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General NPI Number Information
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NPI Number | 1154116598
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Entity Type | Individual
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Provider Name | CRYSTAL MARIE RIVERA PEREZ ATO
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Gender | Female
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 759 AVE AVELINO VICENTE
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City | SAN JUAN
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State | PR
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Zip | 00909-2538
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Country | US
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Telephone | 787-303-9662
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 AV. LAS PALMAS COND. PUERTA DE LA BAHIA APT. #912
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-202-3457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2703-1
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License Number State | PR
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