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General NPI Number Information
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NPI Number | 1962369405
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Entity Type | Individual
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Provider Name | NAYELIS PELLOT CORCHADO SR.
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Gender | Male
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | CALLE JUAN SAN ANTONIO,BO PUEBLO.
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City | MOCA
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State | PR
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Zip | 00676
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Country | US
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Telephone | 787-818-0100
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Fax | 787-877-4513
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Provider Business Mailing Address
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Address Line | URB. MANUEL CORCHADO CALLE GARDENIA #59
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 939-406-7060
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 008028
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License Number State | PR
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