Healthcare Provider Details

I. General information

NPI: 1558206193
Provider Name (Legal Business Name): CCM THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 14 KM 48.6 BO. ASOMANTE
AIBONITO PR
00705
US

IV. Provider business mailing address

PO BOX 381
AIBONITO PR
00705-0381
US

V. Phone/Fax

Practice location:
  • Phone: 787-735-8389
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARLA CRISTINA MALAVE RODRIGUEZ
Title or Position: PRESIDENT
Credential: SLP
Phone: 787-215-3256