MEDICARE: MS. CONCETTA BRUNO MA

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	SA1471	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083639322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CONCETTA BRUNO MA

Provider Business Mailing Address
First Line	:	1000 QUAYSIDE TER APT 1605
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-2220
Country	:	US
Telephone Number	:	130-586-4378
Fax Number	:	305-864-7114

Provider Business Practice Location Address
First Line	:	1000 QUAYSIDE TER APT 1605
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-2220
Country	:	US
Telephone Number	:	305-864-3788
Fax Number	:	305-864-7114

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/20/2023

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Directions to “ MS. CONCETTA BRUNO MA” Practice Location

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