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NPI Code Detail

MEDICARE: CORALYS AURORA ROSA MARCANO MS, SLP

MEDICARE: CORALYS AURORA ROSA MARCANO MS, SLP
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
1235Z00000XSpeech-Language Pathologist4564PR

General Provider Information

NPI Number : 1811774763
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORALYS AURORA ROSA MARCANO MS, SLP
Provider Business Mailing Address
First Line : HC 4 BOX 46094
Second Line :
City : CAGUAS
State : PR
Zip : 00727-9691
Country : US
Telephone Number : 939-969-0095
Fax Number :
Provider Business Practice Location Address
First Line : 759 AVE AVELINO VICENTE
Second Line :
City : SAN JUAN
State : PR
Zip : 00909-2538
Country : US
Telephone Number : 787-303-9662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2023
Last Update Date : 01/20/2026

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