MEDICARE: FLAMENCO ARTS & LANGUAGE, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1023873270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLAMENCO ARTS & LANGUAGE, LLC.

Provider Business Mailing Address
First Line	:	10986 SW 75TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-2740
Country	:	US
Telephone Number	:	305-338-1296
Fax Number	:

Provider Business Practice Location Address
First Line	:	6420 SW 88TH PATH
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-2473
Country	:	US
Telephone Number	:	305-338-1296
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST/OWNER
Name	:	MRS. CAROLINA CELESTE MELCON
Credential	:	M.S., CCC-SLP
Telephone Number	:	305-338-1296

Provider Enumeration Date	:	02/16/2024
Last Update Date	:	02/16/2024

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Directions to “FLAMENCO ARTS & LANGUAGE, LLC. ” Practice Location

Language	Start Address	Practice Location

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