Provider Demographics
NPI:1619256542
Name:GAUTIER, YARITZA
Entity Type:Individual
Prefix:MS
First Name:YARITZA
Middle Name:
Last Name:GAUTIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CALLE TITO RODRIGUEZ
Mailing Address - Street 2:ALTOS DE FLORIDA
Mailing Address - City:FLORIDA
Mailing Address - State:PR
Mailing Address - Zip Code:00650-9314
Mailing Address - Country:US
Mailing Address - Phone:787-669-4421
Mailing Address - Fax:
Practice Address - Street 1:275 CALLE TITO RODRIGUEZ
Practice Address - Street 2:ALTOS DE FLORIDA
Practice Address - City:FLORIDA
Practice Address - State:PR
Practice Address - Zip Code:00650-9314
Practice Address - Country:US
Practice Address - Phone:787-669-4421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR995225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation