MEDICARE: LEOANY VAZQUEZ ACOSTA SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA23734	FL

General Provider Information

NPI Number	:	1003642380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEOANY VAZQUEZ ACOSTA SLP

Provider Business Mailing Address
First Line	:	138 W 8TH ST APT 17
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4236 W 16TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7624
Country	:	US
Telephone Number	:	786-409-2646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2024
Last Update Date	:	04/06/2026

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Directions to “ LEOANY VAZQUEZ ACOSTA SLP” Practice Location

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