MEDICARE: MARIA EUGENIA MARIN GIMON

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

General Provider Information

NPI Number	:	1740011840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA EUGENIA MARIN GIMON

Provider Business Mailing Address
First Line	:	3915 TOWNSHIP SQUARE BLVD APT 1423
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-5394
Country	:	US
Telephone Number	:	407-793-0675
Fax Number	:

Provider Business Practice Location Address
First Line	:	3915 TOWNSHIP SQUARE BLVD APT 1423
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-5394
Country	:	US
Telephone Number	:	407-793-0675
Fax Number	:

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

Provider Enumeration Date	:	08/09/2024
Last Update Date	:	08/09/2024

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Directions to “ MARIA EUGENIA MARIN GIMON ” Practice Location

Language	Start Address	Practice Location

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