Organization
PEKES EN DESARROLLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA GAVILAN OTL (DIRECTORA CLINICA/T.O)
(787) 292-2534
Entity
Organization
Contact information
Practice address
160 MARGINAL LAGO ALTO, PLAZA SAN MIGUEL 207, TRUJILLO ALTO, PR 00976-3906
(787) 292-2534
Mailing address
160 MARGINAL LAGO ALTO, PLAZA SAN MIGUEL 207, TRUJILLO ALTO, PR 00976-3906
(787) 292-2534
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
689
PR
261QD1600X
Developmental Disabilities Clinic/Center
Primary
810
PR
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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