Individual provider Active NPI

Gladys Diaz de Jesus

  • Speech-Language Assistant
  • Fajardo, PR
National Provider Identifier
1558245779
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
002000 Issued in PR
Practice address
A49 Calle Marginal
Urbanizacion Baralt
Fajardo, PR 00738-3759
Phone
(787) 801-2966
NPI assigned
Aug 1, 2025
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 002000 PR Primary

Addresses

Primary practice location

A49 Calle Marginal
Urbanizacion Baralt
Fajardo, PR 00738-3759

Mailing address

A10 Calle Marginal
Yabucoa, PR 00767-3900
Phone (787) 909-6051

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
002000PRMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1558245779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A10 CALLE MARGINAL",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "007673900",
            "telephone_number": "787-909-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A49 CALLE MARGINAL",
            "address_2": "URBANIZACION BARALT",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383759",
            "telephone_number": "787-801-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ DE JESUS",
        "first_name": "GLADYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "PR",
            "license": "002000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fajardo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.