MEDICARE: PATRICIA MARINUCHI 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	SA 9445	FL

General Provider Information

NPI Number	:	1831408517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MARINUCHI SLP

Provider Business Mailing Address
First Line	:	3401 SW 116TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3333
Country	:	US
Telephone Number	:	305-559-3762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 WEST AVE APT 1411
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4728
Country	:	US
Telephone Number	:	305-778-9198
Fax Number	:

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

Provider Enumeration Date	:	09/29/2010
Last Update Date	:	09/29/2010

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Directions to “ PATRICIA MARINUCHI SLP” Practice Location

Language	Start Address	Practice Location

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