Healthcare Provider Details

I. General information

NPI: 1760695613
Provider Name (Legal Business Name): MARGARITA M HURTADO MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

R5 AVE CUPEY GDNS
SAN JUAN PR
00926-7333
US

IV. Provider business mailing address

18 VALLE ESCONDIDO
GUAYNABO PR
00971-8001
US

V. Phone/Fax

Practice location:
  • Phone: 787-292-0903
  • Fax:
Mailing address:
  • Phone: 787-349-4167
  • Fax: 787-292-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number589
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: