Healthcare Provider Details

I. General information

NPI: 1154238764
Provider Name (Legal Business Name): ANGELIZ RIVERA SOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 110, KM. 23.3, BO. CEIBA BAJA, AGUADILLA, PR 0060
AGUADILLA PR
00690
US

IV. Provider business mailing address

2050 CALLE JOSE PALAU
SAN ANTONIO PR
00690-1257
US

V. Phone/Fax

Practice location:
  • Phone: 939-313-0343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7968
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: