MEDICARE: DR. LOIS E CAPUZZI PHD CCCSLP

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	SA2993	FL

General Provider Information

NPI Number	:	1114119716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOIS E CAPUZZI PHD CCCSLP

Provider Business Mailing Address
First Line	:	1829 SW 17TH STREET
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1829 SW 17TH ST
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6406
Country	:	US
Telephone Number	:	561-736-5302
Fax Number	:

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

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	08/16/2007

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Directions to “ DR. LOIS E CAPUZZI PHD CCCSLP” Practice Location

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