Healthcare Provider Details

I. General information

NPI: 1013824580
Provider Name (Legal Business Name): SAMARIS MENDEZ SOTO MS. SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERRA #2 KM 95. 0 BO. YEGUADA
CAMUY PR
00627
US

IV. Provider business mailing address

20710 CALLE JESUS SANCHEZ
QUEBRADILLAS PR
00678
US

V. Phone/Fax

Practice location:
  • Phone: 787-680-4659
  • Fax:
Mailing address:
  • Phone: 787-922-4425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number004176
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: