Healthcare Provider Details

I. General information

NPI: 1629304605
Provider Name (Legal Business Name): JULIANNE MARIE CIONFOLO CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2009
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CLINT MOORE RD SUITE 120
BOCA RATON FL
33487-2768
US

IV. Provider business mailing address

5036 SOLAR POINT DR
GREENACRES FL
33463-5918
US

V. Phone/Fax

Practice location:
  • Phone: 561-939-0300
  • Fax:
Mailing address:
  • Phone: 561-433-1104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA3782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: