Healthcare Provider Details

I. General information

NPI: 1588173934
Provider Name (Legal Business Name): CECELIA BRUNS MS, CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 HOLLYWOOD BLVD STE 201
HOLLYWOOD FL
33021-6420
US

IV. Provider business mailing address

8010 CLEARY BLVD APT 101
PLANTATION FL
33324-1348
US

V. Phone/Fax

Practice location:
  • Phone: 954-603-1881
  • Fax:
Mailing address:
  • Phone: 757-403-3300
  • Fax: 757-403-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ8346
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: