Healthcare Provider Details

I. General information

NPI: 1184540098
Provider Name (Legal Business Name): PAOLA M MARQUEZ SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 CARR 844
SAN JUAN PR
00926-4446
US

IV. Provider business mailing address

894 CALLE 2
SAN JUAN PR
00924-5220
US

V. Phone/Fax

Practice location:
  • Phone: 787-647-1266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4594
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: