Healthcare Provider Details

I. General information

NPI: 1720993991
Provider Name (Legal Business Name): SPINA BIFIDA & HYDROCEPHALUS ASSOCIATION OF PUERTO RICO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. LOMAS VERDES X-49, NOGAL AVE.
BAYAMON PR
00956
US

IV. Provider business mailing address

PO BOX 8262
BAYAMON PR
00960-8262
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-0033
  • Fax:
Mailing address:
  • Phone: 787-740-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LYLETTE AVILES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 787-740-0033