Provider Demographics
NPI:1003884032
Name:MARRERO SANCHEZ, VYLSA E (AUD)
Entity Type:Individual
Prefix:
First Name:VYLSA
Middle Name:E
Last Name:MARRERO SANCHEZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3469
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-3469
Mailing Address - Country:US
Mailing Address - Phone:787-790-2130
Mailing Address - Fax:787-778-7439
Practice Address - Street 1:652 AVE SAN PATRICIO
Practice Address - Street 2:SUMMIT HILLS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4509
Practice Address - Country:US
Practice Address - Phone:787-792-0635
Practice Address - Fax:787-792-0635
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00524231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR998189OtherMEDICARE MUCHO MAS-MMM
PR9650041OtherHUMANA HEALTH PLAN
PR0057318Medicare ID - Type Unspecified
PRQ46964Medicare UPIN