Healthcare Provider Details

I. General information

NPI: 1558278911
Provider Name (Legal Business Name): PAOLA BADILLO GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

HC 6 BOX 64703
AGUADILLA PR
00603-9843
US

IV. Provider business mailing address

HC 6 BOX 64703
AGUADILLA PR
00603-9843
US

V. Phone/Fax

Practice location:
  • Phone: 787-214-5963
  • Fax:
Mailing address:
  • Phone: 787-214-5963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6701-1
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: