Provider Demographics
NPI:1275983181
Name:RENTAS, YADIRA M (OTR/L)
Entity Type:Individual
Prefix:
First Name:YADIRA
Middle Name:M
Last Name:RENTAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 10 BOX 10194
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9976
Mailing Address - Country:US
Mailing Address - Phone:787-637-4620
Mailing Address - Fax:
Practice Address - Street 1:RR 10 BOX 10194
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9976
Practice Address - Country:US
Practice Address - Phone:787-637-4620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000155225X00000X, 225XF0002X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000000216929OtherTHE AMERICAN OCCUPATIONAL THERAPY ASSOCIATION
PR000155OtherPR OFFICE OF REGULATION & CERTIFICATION OF HEALTH PROFFESIONALS
MDAA216929OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY, INC.