Provider Demographics
NPI:1841335841
Name:BOCACHICA, LUISA (RPT)
Entity type:Individual
Prefix:MRS
First Name:LUISA
Middle Name:
Last Name:BOCACHICA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. LOS CAOBOS 2191CALLE NARANJO
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2706
Mailing Address - Country:US
Mailing Address - Phone:787-844-4178
Mailing Address - Fax:
Practice Address - Street 1:URB. LOS CAOBOS 2191CALLE NARANJO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2706
Practice Address - Country:US
Practice Address - Phone:787-844-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000298208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation