MEDICARE: VINCENT MICHAEL DELGIUDICE MSCCC-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	235Z00000X	Speech-Language Pathologist	SP-1982	NV

General Provider Information

NPI Number	:	1407352511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT MICHAEL DELGIUDICE MSCCC-SLP

Provider Business Mailing Address
First Line	:	1453 EUROPEAN DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4022
Country	:	US
Telephone Number	:	702-558-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 E PEBBLE RD STE 115
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-3145
Country	:	US
Telephone Number	:	702-558-9900
Fax Number	:

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

Provider Enumeration Date	:	04/05/2018
Last Update Date	:	04/17/2018

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Directions to “ VINCENT MICHAEL DELGIUDICE MSCCC-SLP” Practice Location

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