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NPI Code Detail

MEDICARE: MELISSA LEA CORCOS MS, CCC-SLP

MEDICARE: MELISSA LEA CORCOS MS, CCC-SLP
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
1235Z00000XSpeech-Language PathologistSA13925FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174938443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA LEA CORCOS MS, CCC-SLP
Provider Business Mailing Address
First Line : 1790 SW 43RD WAY
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33317-5701
Country : US
Telephone Number : 855-442-2454
Fax Number : 954-206-7699
Provider Business Practice Location Address
First Line : 1790 SW 43RD WAY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33317-5701
Country : US
Telephone Number : 855-442-2454
Fax Number : 954-206-7699
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2014
Last Update Date : 11/21/2017

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Directions to “ MELISSA LEA CORCOS MS, CCC-SLP” Practice Location

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