Provider Demographics
NPI:1174069751
Name:HABLAME CLINICA TERAPEUTICA
Entity type:Organization
Organization Name:HABLAME CLINICA TERAPEUTICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANEZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-929-1513
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-0686
Mailing Address - Country:US
Mailing Address - Phone:787-929-1513
Mailing Address - Fax:
Practice Address - Street 1:CARR 153 KM 12.4 LOCAL 3
Practice Address - Street 2:BO LAS FLORES
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-9998
Practice Address - Country:US
Practice Address - Phone:787-929-1513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR978261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech