Healthcare Provider Details

I. General information

NPI: 1093440877
Provider Name (Legal Business Name): SOMOS SPEECH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 RODMAN ST APT 3D
HOLLYWOOD FL
33020-6065
US

IV. Provider business mailing address

1818 RODMAN ST APT 3D
HOLLYWOOD FL
33020-6065
US

V. Phone/Fax

Practice location:
  • Phone: 305-915-8445
  • Fax:
Mailing address:
  • Phone: 305-915-8445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. BIANCA D ANGHEL
Title or Position: SLP/ OFFICER
Credential: MS CCC SLP
Phone: 305-915-8445