MEDICARE: NELYMAR ALICEA SANTIAGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	7468	PR

General Provider Information

NPI Number	:	1235006818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NELYMAR ALICEA SANTIAGO

Provider Business Mailing Address
First Line	:	CALLE 4 R2 URB. SANTA ELENA
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00957
Country	:	US
Telephone Number	:	787-233-2747
Fax Number	:

Provider Business Practice Location Address
First Line	:	2U5 AVE LAUREL
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00956-3374
Country	:	US
Telephone Number	:	787-233-2747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	10/24/2025

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Directions to “ NELYMAR ALICEA SANTIAGO ” Practice Location

Language	Start Address	Practice Location

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