Provider Demographics
NPI:1730516584
Name:PUERTO RICO ASSITIVE TECHNOLOGY PROGRAM
Entity type:Organization
Organization Name:PUERTO RICO ASSITIVE TECHNOLOGY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-764-0000
Mailing Address - Street 1:1187 CALLE FLAMBOYAN JARDIN BOTANICO SUR
Mailing Address - Street 2:UNIVERSIDAD DE PUERTO RICO-ADMINISTRACION CENTRAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-1117
Mailing Address - Country:US
Mailing Address - Phone:787-764-0000
Mailing Address - Fax:
Practice Address - Street 1:CALLE 17 ESQUINA 6 JARDIN BOTANICO NORTE
Practice Address - Street 2:URB. VILLA NEVAREZ
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-764-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF PUERTO RICO-CENTRAL ADMINISTRATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-10
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty