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NPI 1851789812

NPI 1851789812 : BEATRIZ MALDONADO OTL : RIO GRANDE, PR

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General NPI Number Information
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    NPI Number           |    1851789812
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    Entity Type          |    Individual 
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    Provider Name        |    BEATRIZ MALDONADO OTL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/29/2014
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    Last Update Date     |    12/29/2014
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Provider Practice Location Address
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    Address Line         |    CALLE / CEDRO #418 VISTAS DE RIO GRANDE II
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    City                 |    RIO GRANDE
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    State                |    PR
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    Zip                  |    00745
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    Country              |    US
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    Telephone            |    787-949-7592
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    VISTAS DE RIO GRANDE I I CALLE/ CEDRO #418
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    City                 |    RIO GRANDE
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    State                |    PUERTO RICO
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    Zip                  |    00745
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    Country              |    UM
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    Telephone            |    787-949-7592
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    754
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    License Number State |    PR
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