Provider Demographics
NPI:1962393918
Name:OLIVER, MARINES
Entity type:Individual
Prefix:
First Name:MARINES
Middle Name:
Last Name:OLIVER
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:URB VILLA ANDALUCIA
Mailing Address - Street 2:AVE FRONTERA H-53
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-423-3318
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA ANDALUCIA
Practice Address - Street 2:AVE FRONTERA H-53
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-423-3318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist