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NPI 1356068712

NPI 1356068712 : FABIOLA ANDREA BERROCAL CCC-SLP : MAYAGUEZ, PR

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General NPI Number Information
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    NPI Number           |    1356068712
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    Entity Type          |    Individual 
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    Provider Name        |    FABIOLA ANDREA BERROCAL CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/25/2022
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    Last Update Date     |    01/02/2026
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Provider Practice Location Address
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    Address Line         |    510 AVE HOSTOS VISTA VERDE SHOPPING CENTER SUITE 112
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    City                 |    MAYAGUEZ
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    State                |    PR
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    Zip                  |    00682-9998
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    Country              |    US
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    Telephone            |    787-204-9041
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    309 ESTANCIAS NITO MARTI 
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    City                 |    CABO ROJO
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    State                |    PR
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    Zip                  |    00923-9998
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    Country              |    US
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    Telephone            |    939-640-2215
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    4620
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    License Number State |    PR
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