Healthcare Provider Details

I. General information

NPI: 1013840131
Provider Name (Legal Business Name): NILKA ZOE GORDILLO AVILES M.S., SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 821
JAYUYA PR
00664-0821
US

IV. Provider business mailing address

PO BOX 821
JAYUYA PR
00664-0821
US

V. Phone/Fax

Practice location:
  • Phone: 787-467-5697
  • Fax:
Mailing address:
  • Phone: 787-467-5697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4630
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: