Individual provider Active NPI

Jidaliz Adorno Alicea, M.S.SLP

  • Speech-Language Pathologist
  • Toa Alta, PR
National Provider Identifier
1487104311
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
004115-1 Issued in PR
Practice address
RR 2 Box 2006
Toa Alta, PR 00953-8973
Phone
(787) 414-3507
NPI assigned
Oct 4, 2016
Last updated
Oct 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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 004115-1 PR Primary

Addresses

Primary practice location

RR 2 Box 2006
Toa Alta, PR 00953-8973

Mailing address

RR 2 Box 2006
Toa Alta, PR 00953-8973
Phone (787) 414-3507

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
004115-1PRMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1487104311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 2006",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009538973",
            "telephone_number": "787-414-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 2006",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009538973",
            "telephone_number": "787-414-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADORNO ALICEA",
        "first_name": "JIDALIZ",
        "name_prefix": "Mrs.",
        "credential": "M.S.SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "004115-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.