Provider Demographics
NPI:1508750241
Name:GONZALEZ CRUZ, ILLIANA Y
Entity type:Individual
Prefix:
First Name:ILLIANA
Middle Name:Y
Last Name:GONZALEZ CRUZ
Suffix:
Gender:X
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. VELOMAS CALLE CENTRAL
Mailing Address - Street 2:COLOSO 231
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:US
Mailing Address - Phone:787-614-0500
Mailing Address - Fax:
Practice Address - Street 1:URB. VELOMAS CALLE CENTRAL
Practice Address - Street 2:COLOSO 231
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-614-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14002355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant