Provider Demographics
NPI:1407445232
Name:PERALES, MARIA CRISTINA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CRISTINA
Last Name:PERALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 845 KM 2.2 URB. FAIRVIEW
Mailing Address - Street 2:D-35
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-738-3688
Mailing Address - Fax:
Practice Address - Street 1:CARR 845 KM 2.2 URB. FAIRVIEW
Practice Address - Street 2:D-35
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-2442
Practice Address - Country:US
Practice Address - Phone:787-738-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKCF-267Medicaid