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General NPI Number Information
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NPI Number | 1427713452
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Entity Type | Individual
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Provider Name | MARINA TAYLOR ANASTACIO SLP
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Gender | Female
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 8350 NW 52ND TER STE 301
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City | DORAL
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State | FL
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Zip | 33166-7708
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Country | US
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Telephone | 305-273-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 1884 W 64TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-6018
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Country | US
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Telephone | 305-613-0920
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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 | SZ11584
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License Number State | FL
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