Healthcare Provider Details

I. General information

NPI: 1679407332
Provider Name (Legal Business Name): MASTICA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET 15, NUM.X5, URB.VILLA LOS SANTOS, BO, HATO ABAJO STREET 15, NUM. X5, URB. VILLA LOS SANTOS, BO. HATO ABA
ARECIBO PR
00612-3114
US

IV. Provider business mailing address

STREET 15, NUM.X5, URB.VILLA LOS SANTOS, BO, HATO ABAJO STREET 15, NUM. X5, URB. VILLA LOS SANTOS, BO. HATO ABA
ARECIBO PR
00612-3114
US

V. Phone/Fax

Practice location:
  • Phone: 787-705-0892
  • Fax:
Mailing address:
  • Phone: 787-705-0892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: SAYRIN BONILLA SANABRIA
Title or Position: OWNER/DIRECTOR
Credential: PHL
Phone: 787-326-1716