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General NPI Number Information
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NPI Number | 1477977007
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Entity Type | Individual
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Provider Name | CARMEN M. CORTES M.A., CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 13601 SW 80TH CT
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City | PALMETTO BAY
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State | FL
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Zip | 33158-1137
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Country | US
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Telephone | 786-999-9301
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Fax |
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Provider Business Mailing Address
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Address Line | 13601 SW 80TH CT
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City | PALMETTO BAY
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State | FL
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Zip | 33158-1137
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Country | US
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Telephone | 786-999-9301
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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 | 3769
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License Number State | FL
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