Healthcare Provider Details

I. General information

NPI: 1669389185
Provider Name (Legal Business Name): PAOLA VIVIANA ROSADO SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO COCOS, CARR 481 KM 1.7
QUEBRADILLAS PR
00678
US

IV. Provider business mailing address

BO SAN ANTONIO SEC MONTADERO CARR 113 KM 14.8
QUEBRADILLAS PR
00678
US

V. Phone/Fax

Practice location:
  • Phone: 787-422-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5143-1
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: