MEDICARE: SULEIKA MORALES COLON SLPA

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	40419	TX

General Provider Information

NPI Number	:	1528794971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SULEIKA MORALES COLON SLPA

Provider Business Mailing Address
First Line	:	3402 BRASILIA
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78526-1229
Country	:	US
Telephone Number	:	956-572-1908
Fax Number	:	888-388-8379

Provider Business Practice Location Address
First Line	:	524 E LOS EBANOS BLVD STE B
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-4254
Country	:	US
Telephone Number	:	956-572-1908
Fax Number	:	888-388-8379

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

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/28/2022

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