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NPI Code Detail

MEDICARE: YARITZA RIVERA AVILES OTL

MEDICARE:   YARITZA  RIVERA AVILES  OTL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist924PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1924OTHERPROCCUPATIONAL THERAPIST LICENCE

General Provider Information

NPI Number : 1093952368
Entity Type Code : Individual
Provider Name (Legal Business Name) : YARITZA RIVERA AVILES OTL
Provider Business Mailing Address
First Line : CONDOMINIO PARQUE DEL LAGO
Second Line : 100 CALLE 13 BUZON 406
City : TOA BAJA
State : PR
Zip : 00949-3239
Country : US
Telephone Number : 787-923-2408
Fax Number : 939-336-5897
Provider Business Practice Location Address
First Line : CONDOMINIO PARQUE DEL LAGO
Second Line : 100 CALLE 13 BOX 406
City : TOA BAJA
State : PR
Zip : 00949-3239
Country : US
Telephone Number : 787-923-2408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2009
Last Update Date : 08/08/2016

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Directions to “ YARITZA RIVERA AVILES OTL” Practice Location

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