Provider Demographics
NPI:1639978893
Name:SPEECH LOFT
Entity type:Organization
Organization Name:SPEECH LOFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:ALICEBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCD
Authorized Official - Phone:787-629-1190
Mailing Address - Street 1:URB LA QUINTA CALLE VERSACE G4
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-4123
Mailing Address - Country:US
Mailing Address - Phone:787-629-1190
Mailing Address - Fax:
Practice Address - Street 1:209
Practice Address - Street 2:CALLE 25DE JULIO
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3564
Practice Address - Country:US
Practice Address - Phone:787-629-1190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech