Healthcare Provider Details

I. General information

NPI: 1700716057
Provider Name (Legal Business Name): KATHERINE VERGEL M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10791 NW 21ST ST
CORAL SPRINGS FL
33071-4217
US

IV. Provider business mailing address

10791 NW 21ST ST
CORAL SPRINGS FL
33071-4217
US

V. Phone/Fax

Practice location:
  • Phone: 305-588-2287
  • Fax:
Mailing address:
  • Phone: 305-588-2287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ12799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: