Provider Demographics
NPI:1518759091
Name:PEREZ ROBLES, MIGDALIZ (OTL)
Entity type:Individual
Prefix:
First Name:MIGDALIZ
Middle Name:
Last Name:PEREZ 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:VEGA SERENA 140 ROSA MARIA STREET
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-608-0407
Mailing Address - Fax:
Practice Address - Street 1:VEGA SERENA 104 BEATRICE STREET
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-5860
Practice Address - Country:US
Practice Address - Phone:787-608-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR911225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty