Provider Demographics
NPI:1326124405
Name:RIOS CRUZ, AWILDA (OT)
Entity Type:Individual
Prefix:
First Name:AWILDA
Middle Name:
Last Name:RIOS CRUZ
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:B20 CALLE PFC CARLOS J LOZADA
Mailing Address - Street 2:JARDINES DE CAGUAS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-2502
Mailing Address - Country:US
Mailing Address - Phone:787-744-2172
Mailing Address - Fax:787-744-2172
Practice Address - Street 1:B20 CALLE PFC CARLOS J LOZADA
Practice Address - Street 2:JARDINES DE CAGUAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-2502
Practice Address - Country:US
Practice Address - Phone:787-744-2172
Practice Address - Fax:787-744-2172
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR597225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist