Provider Demographics
NPI:1407175979
Name:BALAGTAS, WANDA (OTR/L)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:BALAGTAS
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 1:210 C/535 #402 CONDO TURQUESA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-3131
Mailing Address - Country:US
Mailing Address - Phone:787-810-3247
Mailing Address - Fax:787-783-1325
Practice Address - Street 1:HOSPITAL DEL NINO DE PUERTO RICO
Practice Address - Street 2:APARTADO 2124
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-2124
Practice Address - Country:US
Practice Address - Phone:787-783-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR792225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics