Provider Demographics
NPI:1487989505
Name:NAZARIO, ASTRID K (SLP)
Entity type:Individual
Prefix:MISS
First Name:ASTRID
Middle Name:K
Last Name:NAZARIO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LOS CAOBOS
Mailing Address - Street 2:CALLE TABONUCO 2935
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716 2737
Mailing Address - Country:UM
Mailing Address - Phone:787-223-5482
Mailing Address - Fax:
Practice Address - Street 1:CALLE DR. VADI
Practice Address - Street 2:68
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:UM
Practice Address - Phone:787-806-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1585-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist