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General NPI Number Information
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NPI Number | 1447653779
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Entity Type | Organization
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Legal Business Name | FLORIDA SPEECH & NEUROREHAB CENTER, LLC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 331 SW 184TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-5425
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Country | US
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Telephone | 305-608-6665
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Fax |
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Provider Business Mailing Address
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Address Line | 331 SW 184TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-5425
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Country | US
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Telephone | 305-608-6665
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SASHA NOGUERAS PEREZ
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Credential | M.S. CCC-SLP
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Telephone | 305-608-6665
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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 | SA4740
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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 | SA10384
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License Number State | FL
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