Healthcare Provider Details

I. General information

NPI: 1487127965
Provider Name (Legal Business Name): ZULEYKA COLON RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2019
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO COMERCIAL LOCAL 1 66 URB CATALANA
BARCELONETA PR
00617
US

IV. Provider business mailing address

PO BOX 140053
ARECIBO PR
00614-0053
US

V. Phone/Fax

Practice location:
  • Phone: 787-915-3000
  • Fax:
Mailing address:
  • Phone: 787-915-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number006020
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6105242
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerDRIVERS LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: