Provider Demographics
NPI:1003261678
Name:CENTRO TERAPEUTICO ESTRELLA
Entity Type:Organization
Organization Name:CENTRO TERAPEUTICO ESTRELLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGY
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARANGELIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBRON
Authorized Official - Suffix:
Authorized Official - Credentials:MS SLP
Authorized Official - Phone:787-605-6555
Mailing Address - Street 1:PO. BOX 9115
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613
Mailing Address - Country:US
Mailing Address - Phone:787-605-6555
Mailing Address - Fax:
Practice Address - Street 1:CARR. 490 KM 0.15
Practice Address - Street 2:PLAZA HATO ARRIBA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-605-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty