Individual provider Active NPI

Wisarys Molina Villanueva

  • Speech-Language Pathologist
  • San Juan, PR
National Provider Identifier
1477073203
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4092 Issued in PR
Practice address
465 Ave Hostos Urb. Vedado
San Juan, PR 00918-3014
Phone
(787) 946-4501
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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 4092 PR Primary

Addresses

Primary practice location

465 Ave Hostos Urb. Vedado
San Juan, PR 00918-3014

Mailing address

RR 2 Box 3017
Toa Alta, PR 00953-9664
Phone (787) 464-8082

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
4092PRMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blablao LLC Speech-Language Pathologist Current Accepting new patients
Well&Lean LLC PastSince Jul 17, 2016 Accepting new patients
Well&Lean LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1477073203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 3017",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009539664",
            "telephone_number": "787-464-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 AVE HOSTOS URB. VEDADO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183014",
            "telephone_number": "787-946-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA VILLANUEVA",
        "first_name": "WISARYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "4092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; 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.