Healthcare Provider Details

I. General information

NPI: 1184863169
Provider Name (Legal Business Name): MELANIE CAP SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAKWOOD BLVD STE 130
HOLLYWOOD FL
33020-1956
US

IV. Provider business mailing address

455 NE 2ND ST
BOCA RATON FL
33432-4005
US

V. Phone/Fax

Practice location:
  • Phone: 954-925-3844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ4715
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: