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NPI Code Detail

MEDICARE: MRS. LINA MARGARITA BRUGES AVILA M.A., SLP

MEDICARE: MRS. LINA MARGARITA BRUGES AVILA M.A., 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
1235Z00000XSpeech-Language Pathologist11335NC

General Provider Information

NPI Number : 1912200684
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINA MARGARITA BRUGES AVILA M.A., SLP
Provider Business Mailing Address
First Line : 5945 CLIFFDALE RD STE 1111
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28314-0034
Country : US
Telephone Number : 910-229-3951
Fax Number :
Provider Business Practice Location Address
First Line : 5945 CLIFFDALE RD STE 1111
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28314-0034
Country : US
Telephone Number : 910-229-3951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2010
Last Update Date : 10/08/2015

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