Healthcare Provider Details

I. General information

NPI: 1316830342
Provider Name (Legal Business Name): SALTARINES: TERAPIA PEDIATRICA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE DE LA CRUZ #10 Y #12
RIO GRANDE PR
00983
US

IV. Provider business mailing address

JR8 VIA 16
CAROLINA PR
00983-3925
US

V. Phone/Fax

Practice location:
  • Phone: 939-339-6102
  • Fax:
Mailing address:
  • Phone: 939-339-6102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KASSANDRA VELEZ
Title or Position: PRESIDENT
Credential: PTA
Phone: 939-339-6102