Provider Demographics
NPI:1245436393
Name:PEREZ, JOSEPHINE VAZQUEZ (ATO)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:VAZQUEZ
Last Name:PEREZ
Suffix:
Gender:F
Credentials:ATO
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 11911
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1911
Mailing Address - Country:US
Mailing Address - Phone:787-307-3364
Mailing Address - Fax:
Practice Address - Street 1:RR 9 BOX 887
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9203
Practice Address - Country:US
Practice Address - Phone:787-755-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR107224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant