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General NPI Number Information
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NPI Number | 1356117261
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Entity Type | Organization
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Legal Business Name | SPEECH GUY THERAPY SERVICES INC
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Dates
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Enumeration Date | 12/01/2023
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 315 N STATE ROAD 7 APT 2205
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City | PLANTATION
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State | FL
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Zip | 33317-2864
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Country | US
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Telephone | 347-543-1247
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Fax |
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Provider Business Mailing Address
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Address Line | 6919 W BROWARD BLVD. PMB 296
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City | PLANTATION
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State | FL
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Zip | 33317
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Country | US
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Telephone | 347-543-1247
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARCO ANTONIO CENTENO
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Credential |
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Telephone | 347-543-1247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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