Healthcare Provider Details

I. General information

NPI: 1164345062
Provider Name (Legal Business Name): GISELLY SANTOS TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 19 KM 0.6 BARRIO MONACILLOS
SAN JUAN PR
00926-5548
US

IV. Provider business mailing address

CALLE 4 C31URB. VILLAS DE SAN AGUSTIN CALLE 4 C31 URB. VILLAS DE SAN AGUSTIN
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-2226
  • Fax:
Mailing address:
  • Phone: 787-375-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number3079
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: