Provider Demographics
NPI:1265794416
Name:TORO, MAYRA JENNY (OT)
Entity type:Individual
Prefix:MRS
First Name:MAYRA
Middle Name:JENNY
Last Name:TORO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND SANTA MARIA OFC BUILDING
Mailing Address - Street 2:CALLE FERROCARRIL SUITE 104
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0770
Mailing Address - Country:US
Mailing Address - Phone:939-250-0740
Mailing Address - Fax:
Practice Address - Street 1:COND SANTA MARIA OFC BUILDING
Practice Address - Street 2:CALLE FERROCARRIL SUITE 104
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0770
Practice Address - Country:US
Practice Address - Phone:939-250-0740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00544225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist