Provider Demographics
NPI:1619645496
Name:PROGRESA,LLC
Entity Type:Organization
Organization Name:PROGRESA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DARLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MOLINA TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:787-424-8644
Mailing Address - Street 1:PO BOX 367536
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936
Mailing Address - Country:US
Mailing Address - Phone:787-424-8644
Mailing Address - Fax:
Practice Address - Street 1:3 A CALLE ACUARELA
Practice Address - Street 2:URB MUNOZ RIVERA OFICINA A-9
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-424-8644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-05
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty