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General NPI Number Information
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NPI Number | 1770349698
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Entity Type | Organization
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Legal Business Name | NICOLE KRAFTSOW, LLC
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 14707 S DIXIE HWY STE 211
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City | MIAMI
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State | FL
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Zip | 33176-7951
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Country | US
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Telephone | 786-345-7022
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Fax | 305-564-6934
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Provider Business Mailing Address
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Address Line | 14707 S DIXIE HWY STE 211
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City | MIAMI
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State | FL
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Zip | 33176-7951
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Country | US
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Telephone | 786-345-7022
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE KRAFTSOW
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Credential | CCC-SLP
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Telephone | 786-345-7022
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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 |
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License Number State |
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