Provider Demographics
NPI:1659248664
Name:ACEVEDO RIVERA, JAVIER MANUEL (OTL)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:MANUEL
Last Name:ACEVEDO RIVERA
Suffix:
Gender:M
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 CALLE OSCAR RIVERA
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-8519
Mailing Address - Country:US
Mailing Address - Phone:787-402-9762
Mailing Address - Fax:
Practice Address - Street 1:82 CALLE OSCAR RIVERA
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-8519
Practice Address - Country:US
Practice Address - Phone:787-402-9762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR760225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty