Healthcare Provider Details

I. General information

NPI: 1437067584
Provider Name (Legal Business Name): DIANE M. ALVAREZ TOLEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

M133 METRO PLAZA LAS MONJITAS 1255 AVE. TITO CASTRO, PASEO LAS MONJITAS
PONCE PR
00730
US

IV. Provider business mailing address

HC 9 BOX 1790
PONCE PR
00731-9752
US

V. Phone/Fax

Practice location:
  • Phone: 939-630-0860
  • Fax:
Mailing address:
  • Phone: 787-319-4611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4615
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: