Healthcare Provider Details

I. General information

NPI: 1730022849
Provider Name (Legal Business Name): JEYSHA MARIE HERNANDEZ OROSCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 411 KM 5.0 BO JAGUEY
AGUADA PR
00602-9999
US

IV. Provider business mailing address

HC 1 BOX 5540
MOCA PR
00676-9005
US

V. Phone/Fax

Practice location:
  • Phone: 787-614-8105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number007755
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: