Healthcare Provider Details

I. General information

NPI: 1942127667
Provider Name (Legal Business Name): GABRIELA VICTORIA MALDONADO-SANTIAGO MS-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 CALLE FERROCARRIL
PONCE PR
00717-1110
US

IV. Provider business mailing address

I-156 CALLE REY FELIPE, MANSIONES EN PASEO DE REYES
JUANA DIAZ PR
00795
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-5545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4741
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: