MEDICARE: MC ADVANCE THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1114869161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MC ADVANCE THERAPY LLC

Provider Business Mailing Address
First Line	:	VILLA DEL REY 1 PR-1 C-8
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00754
Country	:	US
Telephone Number	:	787-307-5117
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE 10 EDUARDO
Second Line	:	URB BUNKER APT 1
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-307-5117
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA C PERALES VELEZ
Credential	:	SLP
Telephone Number	:	787-305-5117

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “MC ADVANCE THERAPY LLC ” Practice Location

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