Provider Demographics
NPI:1013728260
Name:SANDOVAL SENERIZ, ANALISSE
Entity type:Individual
Prefix:
First Name:ANALISSE
Middle Name:
Last Name:SANDOVAL SENERIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB PARQUES DE SAN IGNACIO
Mailing Address - Street 2:CALLE 5 J-8
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-463-7831
Mailing Address - Fax:
Practice Address - Street 1:URB. COLLEGE PARK IV #1899 CALLE GLASGOW
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-463-7831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4665235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist