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General NPI Number Information
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NPI Number | 1437519311
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Entity Type | Individual
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Provider Name | KIRIALIS IVETTE CARDONA-GIBOYEAUX OTL
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Gender | Female
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | CARR 2 KM 39.9 BO. ALGARROBO SUITE 105 CENTRO COMERCIAL PLAZA JARDINES
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-654-6493
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Fax | 787-369-0992
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Provider Business Mailing Address
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Address Line | J8 CALLE 7 URB. LA ESPERANZA
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City | VEGA ALTA
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State | PR
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Zip | 00692-6800
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Country | US
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Telephone | 787-239-2401
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Fax | 787-369-0992
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1245
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 1245
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 1245
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License Number State | PR
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