Healthcare Provider Details

I. General information

NPI: 1477280766
Provider Name (Legal Business Name): SPEECH THERAPY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA AGUSTIN RAMOS CALERO
ISABELA PR
00662
US

IV. Provider business mailing address

24390 CALLE RUBEN VEGA
QUEBRADILLAS PR
00678-7283
US

V. Phone/Fax

Practice location:
  • Phone: 939-274-3158
  • Fax:
Mailing address:
  • Phone: 787-422-2291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JONATHAN O CRUZ
Title or Position: CEO
Credential:
Phone: 787-422-2291