Healthcare Provider Details

I. General information

NPI: 1093630865
Provider Name (Legal Business Name): IDALISSE MIGDALIA ZABALETA B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOCIEDAD PRO HOSPITAL DEL NINO CARR 14 KM 0.6 MONACILLO
GUAYNABO PR
00966
US

IV. Provider business mailing address

SOCIEDAD PRO HOSPITAL DEL NINO CARR 14 KM 0.6 MONACILLO
GUAYNABO PR
00966
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 Code2355S0801X
TaxonomySpeech-Language Assistant
License Number007440
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: