MEDICARE: AILEEN ALZOLA M.S., 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	SA10806	FL

General Provider Information

NPI Number	:	1639414659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AILEEN ALZOLA M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	6027 DEVONSHIRE BLVD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4055
Country	:	US
Telephone Number	:	305-345-3656
Fax Number	:

Provider Business Practice Location Address
First Line	:	955 NW 3RD ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33128-1274
Country	:	US
Telephone Number	:	305-548-4020
Fax Number	:

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

Provider Enumeration Date	:	12/03/2012
Last Update Date	:	12/03/2012

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Directions to “ AILEEN ALZOLA M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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