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General NPI Number Information
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NPI Number | 1295987576
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Entity Type | Individual
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Provider Name | GEORGINA MERCEDES DUARTE SLP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 6120 FOREST HILL BLVD APT 209
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-5448
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Country | US
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Telephone | 561-385-0073
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Fax | 561-641-7704
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Provider Business Mailing Address
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Address Line | PO BOX 18663
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City | WEST PALM BEACH
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State | FL
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Zip | 33416-8663
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Country | US
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Telephone | 561-385-0073
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Fax | 561-641-7704
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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 | SA7357
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License Number State | FL
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