Provider Demographics
NPI:1578606570
Name:ARIAS, ANTONIA (LOT)
Entity Type:Individual
Prefix:
First Name:ANTONIA
Middle Name:
Last Name:ARIAS
Suffix:
Gender:F
Credentials:LOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43001
Mailing Address - Street 2:SUITE 217-A
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-6600
Mailing Address - Country:US
Mailing Address - Phone:787-530-9597
Mailing Address - Fax:
Practice Address - Street 1:CALLE AQUAMARINA
Practice Address - Street 2:66, VILLA BLANCA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-1944
Practice Address - Country:US
Practice Address - Phone:787-743-3385
Practice Address - Fax:787-743-1030
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1052225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR06271OtherOCUPATIONAL THERAPY