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NPI Code Detail

MEDICARE: ADELYRIS FERNANDEZ RODRIGUEZ OT

MEDICARE: ADELYRIS FERNANDEZ RODRIGUEZ OT
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
1225XP0200XPediatric Occupational Therapist1231PR

General Provider Information

NPI Number : 1265915623
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELYRIS FERNANDEZ RODRIGUEZ OT
Provider Business Mailing Address
First Line : 1012 CALLE 13
Second Line :
City : SAN JUAN
State : PR
Zip : 00923-2521
Country : US
Telephone Number : 787-923-2721
Fax Number :
Provider Business Practice Location Address
First Line : 1012 CALLE 13
Second Line :
City : SAN JUAN
State : PR
Zip : 00923-2521
Country : US
Telephone Number : 787-923-2721
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2018
Last Update Date : 09/12/2018

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Directions to “ ADELYRIS FERNANDEZ RODRIGUEZ OT” Practice Location

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