Provider Demographics
NPI:1932522679
Name:RESTO, BEATRIZ
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:RESTO
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. LA ESPERANZA,
Mailing Address - Street 2:CALLE 6 F 29
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:UM
Mailing Address - Phone:787-453-4968
Mailing Address - Fax:
Practice Address - Street 1:CATALANA #66
Practice Address - Street 2:EDIFICIO 1
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-493-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13172355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1317OtherLIC PROFESIONAL