MEDICARE: MASTICA 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	235500000X	Speech/Language/Hearing Specialist/Technologist

General Provider Information

NPI Number	:	1679407332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASTICA LLC

Provider Business Mailing Address
First Line	:	STREET 15, NUM.X5, URB.VILLA LOS SANTOS, BO, HATO ABAJO
Second Line	:	STREET 15, NUM. X5, URB. VILLA LOS SANTOS, BO. HATO ABA
City	:	ARECIBO
State	:	PR
Zip	:	00612-3114
Country	:	US
Telephone Number	:	787-705-0892
Fax Number	:

Provider Business Practice Location Address
First Line	:	STREET 15, NUM.X5, URB.VILLA LOS SANTOS, BO, HATO ABAJO
Second Line	:	STREET 15, NUM. X5, URB. VILLA LOS SANTOS, BO. HATO ABA
City	:	ARECIBO
State	:	PR
Zip	:	00612-3114
Country	:	US
Telephone Number	:	787-705-0892
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	SAYRIN BONILLA SANABRIA
Credential	:	PHL
Telephone Number	:	787-326-1716

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “MASTICA LLC ” Practice Location

Language	Start Address	Practice Location

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