MEDICARE: MR. LYMARI RENTAS MALDONADO O.T.

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
1	225X00000X	Occupational Therapist	000873	PR

General Provider Information

NPI Number	:	1437166014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LYMARI RENTAS MALDONADO O.T.

Provider Business Mailing Address
First Line	:	217-A ITURREGUI PLAZA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0000
Country	:	US
Telephone Number	:	787-768-5501
Fax Number	:	787-768-8094

Provider Business Practice Location Address
First Line	:	217-A ITURREGUI PLAZA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-0000
Country	:	US
Telephone Number	:	787-768-5501
Fax Number	:	787-768-8094

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/09/2007

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