Basic Information
| Provider Information | |||||||||
| NPI: | 1033616693 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PINEIRO | ||||||||
| FirstName: | ANETTE | ||||||||
| MiddleName: | AILINE | ||||||||
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| Credential: | OT | ||||||||
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| OtherLastName: | PINEIRO | ||||||||
| OtherFirstName: | ANETTE | ||||||||
| OtherMiddleName: | AILINE | ||||||||
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| OtherCredential: | OT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | SAN ANTONIO DE LA TUNA | ||||||||
| Address2: | 1523 AVE MABODAMACA | ||||||||
| City: | ISABELA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875053988 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 349 HOSTOS SANTANDER SECURITIES PLAZA | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872652300 | ||||||||
| FaxNumber: | 7878311714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2018 | ||||||||
| LastUpdateDate: | 04/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 693 | PR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.