Individual provider Active NPI

Mara Zoe Feliciano, SLP

  • Speech-Language Pathologist
  • Trujillo Alto, PR
National Provider Identifier
1295904712
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
798 Issued in PR
Practice address
Buzon 105 Lago Patillas St. M-15
Ext Ciudad del Lago
Trujillo Alto, PR 00976
Phone
(787) 455-3155
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 798 PR Primary

Addresses

Primary practice location

Buzon 105 Lago Patillas St. M-15
Ext Ciudad del Lago
Trujillo Alto, PR 00976

Mailing address

Buzon 105 Lago Patillas St. M-15
Ext Ciudad del Lago
Trujillo Alto, PR 00976
Phone (787) 455-3155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
798PRMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1295904712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BUZON 105 LAGO PATILLAS ST. M-15",
            "address_2": "EXT CIUDAD DEL LAGO",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-455-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUZON 105 LAGO PATILLAS ST. M-15",
            "address_2": "EXT CIUDAD DEL LAGO",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-455-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO",
        "first_name": "MARA",
        "middle_name": "ZOE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trujillo Alto, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.