MEDICARE: MARIA MONICA BRAVO BUCKINGHAM 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	SA21094	FL

General Provider Information

NPI Number	:	1417169053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA MONICA BRAVO BUCKINGHAM SLP

Provider Business Mailing Address
First Line	:	12900 SAWGRASS PINE CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-4890
Country	:	US
Telephone Number	:	321-697-6609
Fax Number	:

Provider Business Practice Location Address
First Line	:	13574 VILLAGE PARK DR UNIT 200
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-7694
Country	:	US
Telephone Number	:	407-930-1000
Fax Number	:

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

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	03/18/2026

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