Healthcare Provider Details

I. General information

NPI: 1477924785
Provider Name (Legal Business Name): SPEECH SWALLOWING AND HEARING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W 49TH ST STE 322
HIALEAH FL
33012-3407
US

IV. Provider business mailing address

209 N FORT LAUDERDALE BEACH BLVD APT 5A
FORT LAUDERDALE FL
33304-4335
US

V. Phone/Fax

Practice location:
  • Phone: 163-161-2437
  • Fax:
Mailing address:
  • Phone: 163-161-2437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NUBE ROSA ESCOBAR RODRIGUEZ
Title or Position: PRESIDENT
Credential: AU.D./MS/SLP-CCC
Phone: 631-612-8437