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NPI 1700436722

NPI 1700436722 : CYNTHIA GISELLE CASAUDOUMECQ : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1700436722
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    Entity Type          |    Individual 
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    Provider Name        |    CYNTHIA GISELLE CASAUDOUMECQ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/12/2019
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    Last Update Date     |    09/12/2019
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Provider Practice Location Address
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    Address Line         |    7762 N KENDALL DR 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33156-7523
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    Country              |    US
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    Telephone            |    305-598-0229
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10123 SW 156TH AVE 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33196-2689
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    Country              |    US
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    Telephone            |    305-338-0504
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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       |    9291
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    License Number State |    FL
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