Provider Demographics
NPI:1134513526
Name:ROLON, LOURDES SANTOS I (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:SANTOS
Last Name:ROLON
Suffix:I
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 VEREDA DE LAS PALMAS
Mailing Address - Street 2:URB VEREDAS
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9683
Mailing Address - Country:US
Mailing Address - Phone:787-627-5863
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 46938
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-961-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR749235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist