Individual provider Active NPI

Samary Carrasquillo, MS. SLP

  • Speech-Language Pathologist
  • Rio Grande, PR
National Provider Identifier
1376826263
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
880 Issued in PR
Practice address
351 Calle Granada
Urb Los Arboles
Rio Grande, PR 00745-5355
Phone
(787) 556-0196
NPI assigned
Sep 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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 880 PR Primary

Addresses

Primary practice location

351 Calle Granada
Urb Los Arboles
Rio Grande, PR 00745-5355

Mailing address

3 E-33 Jardines de Canovanas
Canovanas, P.R. 00729
UM
Phone (787) 556-0196

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
880PRMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1376826263",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "3 E-33 JARDINES DE CANOVANAS",
            "city": "CANOVANAS",
            "state": "P.R.",
            "postal_code": "00729",
            "telephone_number": "787-556-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 CALLE GRANADA",
            "address_2": "URB LOS ARBOLES",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007455355",
            "telephone_number": "787-556-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO",
        "first_name": "SAMARY",
        "credential": "MS. SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.