MEDICARE: ANDREA CAROLINA BERMUDEZ

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	106002	TX

General Provider Information

NPI Number	:	1083062335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA CAROLINA BERMUDEZ

Provider Business Mailing Address
First Line	:	3415 WELLSPRINGS DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2511
Country	:	US
Telephone Number	:	210-800-4936
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 NE LOOP 410 STE 600
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1619
Country	:	US
Telephone Number	:	210-457-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2016
Last Update Date	:	03/11/2026

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Directions to “ ANDREA CAROLINA BERMUDEZ ” Practice Location

Language	Start Address	Practice Location

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