Healthcare Provider Details

I. General information

NPI: 1053235077
Provider Name (Legal Business Name): CARLA BERNABE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HACIENDA EL MOLINO F7 CALLE OVIEDO
VEGA ALTA PR
00692
US

IV. Provider business mailing address

PO BOX 420
SABANA SECA PR
00952-0420
US

V. Phone/Fax

Practice location:
  • Phone: 787-367-5861
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7940
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: