Provider Demographics
NPI:1154652493
Name:CAMACHO, DOLITZA (OT)
Entity Type:Individual
Prefix:MRS
First Name:DOLITZA
Middle Name:
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 7 BOX 35722
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-9336
Mailing Address - Country:US
Mailing Address - Phone:787-598-0950
Mailing Address - Fax:
Practice Address - Street 1:HC 7 BOX 35722
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-9336
Practice Address - Country:US
Practice Address - Phone:787-598-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR863225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist