| Doctor Name: | IVELISSE VEGUILLA |
| NPI Number: | 1073675088 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | Carr 14 Km 51.8 Int Bo Robles Aibonito, PR - 00705 |
| Business Phone Number: | 7879033776 |
| Business Fax Number: | 7879540517 |
| Mailing Address: | Pmb 169 Box 2400, AIBONITO |
| State: | PR |
| Postal Code: | 00705 |
| Phone Number: | 7879033776 |
| Fax Number: | 7879540517 |
| NPI Enumeration Date: | 12/15/2006 |
| NPI Last Update Date: | 04/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |