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General NPI Number Information
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NPI Number | 1811121882
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Entity Type | Individual
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Provider Name | MARIA CECILIA MAURICIO MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 5190 NW 167TH ST SUITE 117
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 954-868-3088
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Fax | 954-484-7235
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Provider Business Mailing Address
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Address Line | 5190 NW 167TH ST SUITE 117
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 954-868-3088
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Fax | 954-484-7235
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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 | SA 10125
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License Number State | FL
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