Basic Information
| Provider Information | |||||||||
| NPI: | 1598127177 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARROYO | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 889 | ||||||||
| Address2: | |||||||||
| City: | MOROVIS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006870889 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879153000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 66 URB CATALANA | ||||||||
| Address2: | |||||||||
| City: | BARCELONETA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006172725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879153000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2016 | ||||||||
| LastUpdateDate: | 03/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 1044 | PR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
ID Information
| ID | Type | State | Issuer | Description | 1044 | 01 | PR | JUNTA EXAMINADORA TERAPIA OCUPACIONAL | OTHER |