MEDICARE: VICTORIA GUZMAN 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	SA2936	FL
2	235Z00000X	Speech-Language Pathologist	SA 2936	FL

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	:	1699836049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA GUZMAN M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	12448 SW 127TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-6596
Country	:	US
Telephone Number	:	305-255-5980
Fax Number	:	305-255-9766

Provider Business Practice Location Address
First Line	:	12448 SW 127TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-6596
Country	:	US
Telephone Number	:	305-255-5980
Fax Number	:	305-255-9766

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	03/20/2019

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Directions to “ VICTORIA GUZMAN M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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