Nicole Marie Claudio Medina

Individual provider Active NPI Occupational Therapist · Gurabo, PR

NPI 1063297166 · NPPES record last updated Aug 28, 2023

Key facts

NPI
1063297166
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
Practice address
Estancias de Gran Vista
50 Calle San Jose
Gurabo, PR 00778
Phone
(939) 244-4493
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231113003088 PR Practitioner - Occupational Therapist in Private Practice 8224485206 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
MSL Therapeutical Services, PSC Single Specialty Current
since Oct 1, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225X00000X Yes

Addresses

Primary practice location

Estancias de Gran Vista
50 Calle San Jose
Gurabo, PR 00778

Mailing address

Estancias de Gran Vista
50 Calle San Jose
Gurabo, PR 00778

Other providers in Gurabo, PR

All providers in Gurabo, PR · Occupational Therapist in Puerto Rico

Sources for this page

Verify at the official NPI Registry.