Healthcare Provider Details

I. General information

NPI: 1164384426
Provider Name (Legal Business Name): GOLDEN AUDIOLOGY PUERTO RICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

734 COND SERVICENTRO VILLA DEL CARMEN
CIDRA PR
00739
US

IV. Provider business mailing address

URB. LA PLATA M30 CALLE RUBI
CAYEY PR
00736
US

V. Phone/Fax

Practice location:
  • Phone: 787-469-0978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: FRANCHESKA M VEGA CANCEL
Title or Position: AU.D
Credential:
Phone: 787-469-0978