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General NPI Number Information
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NPI Number | 1326863515
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Entity Type | Organization
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Legal Business Name | SENSORY BRAIN LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | BO. CANABONCITO, SECTOR LA SIERRA, CARR. 172 KM.20.6
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 939-317-3984
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Fax |
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Provider Business Mailing Address
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Address Line | URB BAIROA GOLDEN GATE II Q8 CALLE G
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City | CAGUAS
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State | PR
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Zip | 00727-1146
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Country | US
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Telephone | 787-202-9850
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JINNERVA MIRANDA POLANCO
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Credential | SLP
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Telephone | 787-202-9850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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