Provider Demographics
NPI:1275286064
Name:OCASIO, ANGELEE MARIE (OTAL)
Entity Type:Individual
Prefix:
First Name:ANGELEE
Middle Name:MARIE
Last Name:OCASIO
Suffix:
Gender:F
Credentials:OTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 44 BOX 12772
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9735
Mailing Address - Country:US
Mailing Address - Phone:787-678-4689
Mailing Address - Fax:
Practice Address - Street 1:COND. VILLAS BEATRIZ 1001
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-678-4689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR894224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4828376OtherDRIVER LISENCE