MEDICARE: PATRICIA FUENTES 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	SZ6441	FL
2	235Z00000X	Speech-Language Pathologist	SA13367	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	:	1861810020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA FUENTES M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	7561 NW 176TH TER
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-7158
Country	:	US
Telephone Number	:	786-553-7607
Fax Number	:

Provider Business Practice Location Address
First Line	:	18822 NW 80TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5228
Country	:	US
Telephone Number	:	305-904-0285
Fax Number	:

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

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	08/25/2024

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Directions to “ PATRICIA FUENTES M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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