Healthcare Provider Details

I. General information

NPI: 1790659787
Provider Name (Legal Business Name): NAHIR LIZETTE ZAVALA SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 CALLE ALPES
SAN JUAN PR
00920-4156
US

IV. Provider business mailing address

1007 CALLE ALPES
SAN JUAN PR
00920-4156
US

V. Phone/Fax

Practice location:
  • Phone: 787-723-2788
  • Fax:
Mailing address:
  • Phone: 787-723-2788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number624
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: