Provider Demographics
NPI:1558637173
Name:MOJICA, ORYSIA RAE (PT)
Entity Type:Individual
Prefix:MISS
First Name:ORYSIA
Middle Name:RAE
Last Name:MOJICA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:QG20 CALLE 527
Mailing Address - Street 2:URB. COUNTRY CLUB 4TH EXT.
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-2016
Mailing Address - Country:US
Mailing Address - Phone:787-504-2057
Mailing Address - Fax:787-621-4003
Practice Address - Street 1:CARRETERA #2
Practice Address - Street 2:EDIFICIO PEDRO BLANCO LUGO, TORRE MEDICA 1, OFICINA 254
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-4000
Practice Address - Fax:787-621-4003
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist