Healthcare Provider Details

I. General information

NPI: 1568379345
Provider Name (Legal Business Name): DANELIS RIVERA MORALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3R36 AVE LAUREL
BAYAMON PR
00956-3310
US

IV. Provider business mailing address

R8 CALLE IMPERIAL
CAROLINA PR
00987-8548
US

V. Phone/Fax

Practice location:
  • Phone: 787-501-4427
  • Fax:
Mailing address:
  • Phone: 787-668-3138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5112-1
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: