Provider Demographics
NPI:1417747627
Name:FEBUS LEBRON, ARIVETTE (OTA)
Entity type:Individual
Prefix:
First Name:ARIVETTE
Middle Name:
Last Name:FEBUS LEBRON
Suffix:
Gender:
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 CALLE GALAXIA
Mailing Address - Street 2:URB STARLIGHT
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1474
Mailing Address - Country:US
Mailing Address - Phone:787-647-9554
Mailing Address - Fax:
Practice Address - Street 1:3333 CALLE GALAXIA
Practice Address - Street 2:URB STARLIGHT
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1474
Practice Address - Country:US
Practice Address - Phone:787-647-9554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0830224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant