MEDICARE: GCN THERAPIES/GENYLIMA/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	2355S0801X	Speech-Language Assistant

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

General Provider Information

NPI Number	:	1871817056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GCN THERAPIES/GENYLIMA/SLP

Provider Business Mailing Address
First Line	:	5055 S CONGRESS AVE STE 304
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4722
Country	:	US
Telephone Number	:	561-966-3380
Fax Number	:	561-966-7599

Provider Business Practice Location Address
First Line	:	5055 S CONGRESS AVE STE 304
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4722
Country	:	US
Telephone Number	:	561-966-3380
Fax Number	:	561-966-7599

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MR. OCTAVIO LIMA
Credential	:
Telephone Number	:	561-966-3380

Provider Enumeration Date	:	03/17/2010
Last Update Date	:	03/17/2010

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Directions to “GCN THERAPIES/GENYLIMA/SLP ” Practice Location

Language	Start Address	Practice Location

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