Provider Demographics
NPI:1497545347
Name:INSTITUTO MODELO DE ENSENANZA INDIVIDUALIZADA
Entity type:Organization
Organization Name:INSTITUTO MODELO DE ENSENANZA INDIVIDUALIZADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA DEL PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-758-0535
Mailing Address - Street 1:PO BOX 21307
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-1307
Mailing Address - Country:US
Mailing Address - Phone:787-758-0535
Mailing Address - Fax:
Practice Address - Street 1:211 CALLE ARIZMENDI
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3408
Practice Address - Country:US
Practice Address - Phone:787-758-0535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty