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General NPI Number Information
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NPI Number | 1689395303
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Entity Type | Individual
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Provider Name | CAROLINA BOU
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Gender | Female
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 1781 NW 123RD AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4383
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Country | US
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Telephone | 754-423-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 3952 W GARDENIA AVE
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City | WESTON
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State | FL
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Zip | 33332-2473
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Country | US
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Telephone | 954-242-5397
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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 | SZ10853
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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 | SA21702
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License Number State | FL
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