Provider Demographics
NPI:1538582226
Name:RIVERA-ROBLES, JASMIN (OTL)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:
Last Name:RIVERA-ROBLES
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 8292
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-9747
Mailing Address - Country:US
Mailing Address - Phone:787-459-8876
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 8292
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-9747
Practice Address - Country:US
Practice Address - Phone:787-459-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1122225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist