Provider Demographics
NPI:1760374748
Name:CARDONA MATOS, EUYENIS CHALY (THL)
Entity type:Individual
Prefix:
First Name:EUYENIS
Middle Name:CHALY
Last Name:CARDONA MATOS
Suffix:
Gender:F
Credentials:THL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 4785-19
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9283
Mailing Address - Country:US
Mailing Address - Phone:787-328-8961
Mailing Address - Fax:
Practice Address - Street 1:CARR. #2 KM 92.3
Practice Address - Street 2:MARGINAL INTERIOR (AL LADO DEL SUPERMERCADO ECONO)
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-597-5457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR78862355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant