Provider Demographics
NPI:1679138218
Name:FERNANDEZ TORRES, ANGELIS (OTR/L)
Entity type:Individual
Prefix:
First Name:ANGELIS
Middle Name:
Last Name:FERNANDEZ TORRES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO TORRE DE LOS FRAILES
Mailing Address - Street 2:APARTMENT 4M
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-479-0849
Mailing Address - Fax:
Practice Address - Street 1:AV. LUIS VIGOREAUX, CARRETERA #19 KM. 0.6 MONACILLO,
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-783-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1378225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty