Provider Demographics
NPI:1588914329
Name:CARIBBEAN AUDIOLOGY AND BALANCE CSP
Entity type:Organization
Organization Name:CARIBBEAN AUDIOLOGY AND BALANCE CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YADIEL
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:ALAMEDA RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-854-1686
Mailing Address - Street 1:TORRE MEDICA II DR. PEDRO BLANCO LUGO
Mailing Address - Street 2:SUITE 353
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-854-1686
Mailing Address - Fax:787-854-1981
Practice Address - Street 1:TORRE MEDICA II DR. PEDRO BLANCO LUGO
Practice Address - Street 2:SUITE 353
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-1686
Practice Address - Fax:787-854-1981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12710207Y00000X
PR16503207Y00000X
PR601231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty