Individual
JUAN EDGARDO MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.R.
Contact information
Practice address
1010 PASEO DEL VETERANO, PONCE, PR 00716-2001
(787) 812-3030
Mailing address
PO BOX 1856, COAMO, PR 00769-1856
(787) 825-5878
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000275
PR
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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