Healthcare Provider Details

I. General information

NPI: 1265378723
Provider Name (Legal Business Name): JOVIELLYHILMARIE MALDONADO COLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 CARR 664 SUITE1
BARCELONETA PR
00617-3234
US

IV. Provider business mailing address

306 CARR 664 SUITE1
BARCELONETA PR
00617-3234
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-2226
  • Fax:
Mailing address:
  • Phone: 787-783-2226
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3946
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: