Provider Demographics
NPI:1811229024
Name:OT REHABILITATION SERVICES PSC
Entity Type:Organization
Organization Name:OT REHABILITATION SERVICES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OT/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ORTIZ-VICENTE
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:787-460-4671
Mailing Address - Street 1:CALLE 28 T1 #4
Mailing Address - Street 2:URB TURABO GARDENS 2
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5947
Mailing Address - Country:US
Mailing Address - Phone:787-744-4343
Mailing Address - Fax:787-703-4343
Practice Address - Street 1:CALLE 28 T1 #4
Practice Address - Street 2:URB. TURABO GARDENS 2
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-4343
Practice Address - Fax:787-703-4343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR799225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty