Healthcare Provider Details

I. General information

NPI: 1689584930
Provider Name (Legal Business Name): CMRD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

912 CALLE CRUZ
MAYAGUEZ PR
00682-7581
US

IV. Provider business mailing address

35 CALLE VICTORIA
ANASCO PR
00610-2932
US

V. Phone/Fax

Practice location:
  • Phone: 787-445-4343
  • Fax:
Mailing address:
  • Phone: 787-445-4343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CAMELIA M RIVERA DYKYJ
Title or Position: PRESIDENT
Credential: SLP
Phone: 787-445-4343