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General NPI Number Information
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NPI Number | 1437757846
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Entity Type | Individual
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Provider Name | MRS. LAISA EGLI DE CAMPOS BARONI
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Gender | Female
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Dates
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Enumeration Date | 10/16/2020
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 1024 E OSCEOLA PKWY
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City | KISSIMMEE
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State | FL
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Zip | 34744-1607
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Country | US
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Telephone | 407-250-0626
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Fax |
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Provider Business Mailing Address
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Address Line | 14742 CROSSTON BAY CT
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City | ORLANDO
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State | FL
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Zip | 32824-4292
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Country | US
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Telephone | 407-668-0188
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 4516
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 12243
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License Number State | FL
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