MEDICARE: MRS. NICOLE CALIXTO-PEREZ M.S. CFY-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	SZ 5658	FL

General Provider Information

NPI Number	:	1659608875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOLE CALIXTO-PEREZ M.S. CFY-SLP

Provider Business Mailing Address
First Line	:	10300 SW 72ND ST STE 280
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3032
Country	:	US
Telephone Number	:	305-598-5589
Fax Number	:	305-598-5477

Provider Business Practice Location Address
First Line	:	10300 SW 72ND ST STE 280
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3032
Country	:	US
Telephone Number	:	305-598-5589
Fax Number	:	305-598-5477

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

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	10/25/2011

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Directions to “ MRS. NICOLE CALIXTO-PEREZ M.S. CFY-SLP” Practice Location

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