Provider Demographics
NPI:1023360088
Name:CARRASQUILLO, SARA L (TO)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:L
Last Name:CARRASQUILLO
Suffix:
Gender:F
Credentials:TO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7923
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7923
Mailing Address - Country:US
Mailing Address - Phone:787-586-9587
Mailing Address - Fax:
Practice Address - Street 1:8 CALLE BETANCES
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3703
Practice Address - Country:US
Practice Address - Phone:787-586-9587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR970225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist