Provider Demographics
NPI:1073989166
Name:MAS, NATALIA (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:MAS
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15745 SW 89TH AVE
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1908
Mailing Address - Country:US
Mailing Address - Phone:786-586-2465
Mailing Address - Fax:
Practice Address - Street 1:3181 CORAL WAY
Practice Address - Street 2:5TH FLOOR
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3216
Practice Address - Country:US
Practice Address - Phone:305-858-3494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist