Healthcare Provider Details

I. General information

NPI: 1952226581
Provider Name (Legal Business Name): SHAYRA LIZ CRUZ VAZQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO ARENALES BAJOS REPARTO LAS BRISAS 2985 CALLE ADORACION
ISABELA PR
00662
US

IV. Provider business mailing address

REPARTO LAS BRISAS 2985 CALLE ADOREACION
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 787-374-5847
  • Fax:
Mailing address:
  • Phone: 787-374-5847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7380
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: