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General NPI Number Information
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NPI Number | 1174925465
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Entity Type | Individual
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Provider Name | CARMEN LORETO SAN MARTIN M.S SLP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 8510 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33144-4053
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Country | US
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Telephone | 305-266-5353
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Fax | 305-266-6550
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Provider Business Mailing Address
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Address Line | 15260 SW 80TH ST APT 11
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City | MIAMI
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State | FL
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Zip | 33193-1332
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Country | US
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Telephone | 305-266-5353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SZ 6803
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License Number State | FL
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