Provider Demographics
NPI:1033357579
Name:DEMBURG, MEITAL (CFYSLP)
Entity Type:Individual
Prefix:MS
First Name:MEITAL
Middle Name:
Last Name:DEMBURG
Suffix:
Gender:F
Credentials:CFYSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 NE 183 STREET
Mailing Address - Street 2:#2306
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160
Mailing Address - Country:US
Mailing Address - Phone:305-469-6331
Mailing Address - Fax:
Practice Address - Street 1:1811 NE 146TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1423
Practice Address - Country:US
Practice Address - Phone:305-949-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ4698235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist