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General NPI Number Information
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NPI Number | 1497545347
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Entity Type | Organization
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Legal Business Name | INSTITUTO MODELO DE ENSENANZA INDIVIDUALIZADA
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 211 CALLE ARIZMENDI
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City | SAN JUAN
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State | PR
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Zip | 00925-3408
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Country | US
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Telephone | 787-758-0535
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21307
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City | SAN JUAN
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State | PR
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Zip | 00928-1307
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Country | US
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Telephone | 787-758-0535
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR ASSISTANT
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Name | MARIA DEL PILAR SOTO
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Credential |
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Telephone | 787-758-0535
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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 |
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License Number State |
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