Healthcare Provider Details

I. General information

NPI: 1720998941
Provider Name (Legal Business Name): PAULA SOFIA ESTRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 CALLE FAISAN
LUQUILLO PR
00773-3038
US

IV. Provider business mailing address

60 CALLE FAISAN
LUQUILLO PR
00773-3038
US

V. Phone/Fax

Practice location:
  • Phone: 787-315-6812
  • Fax:
Mailing address:
  • Phone: 787-315-6812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5102-1
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: