Individual
JESMARIE MONTES FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
759 AVE AVELINO VICENTE, SAN JUAN, PR 00909-2538
(787) 303-9662
(787) 303-8666
Mailing address
PO BOX 9744, SAN JUAN, PR 00908-0744
(787) 303-9662
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2175-1
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175-1
LICENSE
PR
Enumeration date
04/04/2019
Last updated
05/09/2019
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