MEDICARE: ELIZABETH AGUERO B.S SPECIAL ED 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
1	2355S0801X	Speech-Language Assistant	SI 1329	FL
2	222Q00000X	Developmental Therapist

Other Identifiers

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

General Provider Information

NPI Number	:	1366675415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH AGUERO B.S SPECIAL ED SLP

Provider Business Mailing Address
First Line	:	13926 SW 65TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-1153
Country	:	US
Telephone Number	:	305-205-0259
Fax Number	:	305-205-0259

Provider Business Practice Location Address
First Line	:	13926 SW 65TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-1153
Country	:	US
Telephone Number	:	305-205-0259
Fax Number	:	305-205-0259

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

Provider Enumeration Date	:	08/24/2009
Last Update Date	:	11/04/2011

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