MEDICARE: MS. MONICA L. RAGUSA 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
1	235Z00000X	Speech-Language Pathologist	SA6763	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447358346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONICA L. RAGUSA CCC-SLP

Provider Business Mailing Address
First Line	:	19641 SW 79TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33189-2150
Country	:	US
Telephone Number	:	305-252-5565
Fax Number	:

Provider Business Practice Location Address
First Line	:	11440 N KENDALL DR STE 109
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1024
Country	:	US
Telephone Number	:	305-929-8705
Fax Number	:	305-600-3714

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	11/01/2019

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