Healthcare Provider Details

I. General information

NPI: 1568370633
Provider Name (Legal Business Name): ASHA BEHAVIORAL NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 SE 47TH ST STE 6-7
CAPE CORAL FL
33904-9675
US

IV. Provider business mailing address

1411 SE 47TH ST STE 6-7
CAPE CORAL FL
33904-9675
US

V. Phone/Fax

Practice location:
  • Phone: 786-376-9418
  • Fax:
Mailing address:
  • Phone: 786-376-9418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARLOS SUAREZ
Title or Position: PRESIDENT
Credential:
Phone: 786-376-9418