Healthcare Provider Details

I. General information

NPI: 1447144019
Provider Name (Legal Business Name): YAIMIREX AVILA GUERRERO PHL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/27/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 AVE ESCORIAL
SAN JUAN PR
00920-4764
US

IV. Provider business mailing address

COOP LOS MAESTROS 487 JOSEFA MENDIA
SAN JUAN PR
00923
US

V. Phone/Fax

Practice location:
  • Phone: 939-903-9554
  • Fax:
Mailing address:
  • Phone: 939-903-9554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4422
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: