Provider Demographics
NPI:1831860501
Name:SERVICIOS TERAPEUTICOS NEUROFONI LLC
Entity type:Organization
Organization Name:SERVICIOS TERAPEUTICOS NEUROFONI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIOMARA
Authorized Official - Middle Name:BEATRIZ
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:SPEECH-LANGUAGE THER
Authorized Official - Phone:787-624-4079
Mailing Address - Street 1:HC 4 BOX 6928
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-9513
Mailing Address - Country:US
Mailing Address - Phone:787-624-4079
Mailing Address - Fax:
Practice Address - Street 1:DUFRESNE 19 SUITE 1
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-624-4079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty