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General NPI Number Information
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NPI Number | 1215810569
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Entity Type | Organization
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Legal Business Name | CLINICA DE LINFEDEMA DELIZ BAUZA LLC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 472 EDIFICIO MARVESA SUITE 108, AVENIDA TITO CASTRO
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-232-6510
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Fax | 787-841-7585
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Provider Business Mailing Address
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Address Line | 609 AVENIDA TITO CASTRO SUITE 102 PMB 372
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-232-6510
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Fax | 787-841-7585
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. ELDRA LETICIA DELIZ
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Credential | LCD
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Telephone | 787-232-6510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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