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General NPI Number Information
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NPI Number | 1245293703
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Entity Type | Organization
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Legal Business Name | NANCY DAGOSTINO PA
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3410 NW 21ST ST
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City | COCONUT CREEK
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State | FL
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Zip | 33066-3014
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Country | US
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Telephone | 954-956-0857
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Fax | 954-971-0921
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Provider Business Mailing Address
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Address Line | 3410 NW 21ST ST
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City | COCONUT CREEK
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State | FL
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Zip | 33066-3014
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Country | US
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Telephone | 954-956-0857
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Fax | 954-971-0921
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | MRS. NANCY DAGOSTINO
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Credential | M.S.
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Telephone | 954-326-8195
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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 | SA342
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License Number State | FL
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