Provider Demographics
NPI:1700768090
Name:MOGUEL JIMENEZ, ADRIANA TERESA (LICENCIADA)
Entity type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:TERESA
Last Name:MOGUEL JIMENEZ
Suffix:
Gender:F
Credentials:LICENCIADA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION JARDINES DE MONTE OLIVO
Mailing Address - Street 2:CALLE ZEUS NUM 88
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-214-2316
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION JARDINES DE MONTE OLIVO
Practice Address - Street 2:CALLE ZEUS NUM 88
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-6661
Practice Address - Country:US
Practice Address - Phone:787-214-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist