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General NPI Number Information
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NPI Number | 1437972023
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Entity Type | Individual
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Provider Name | SANDRA JUNCO NODA
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1200 N CENTRAL AVE STE 110
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City | KISSIMMEE
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State | FL
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Zip | 34741-4439
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Country | US
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Telephone | 407-201-7429
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Fax | 877-530-5063
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Provider Business Mailing Address
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Address Line | 11826 HULLBRIDGE CT
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City | ORLANDO
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State | FL
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Zip | 32837-5727
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Country | US
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Telephone | 754-267-4246
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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 | SI7388
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License Number State | FL
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