Provider Demographics
NPI:1093069890
Name:MAGARINO, ROSSANA (MA, SLP)
Entity Type:Individual
Prefix:
First Name:ROSSANA
Middle Name:
Last Name:MAGARINO
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13041 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2123
Mailing Address - Country:US
Mailing Address - Phone:786-715-3883
Mailing Address - Fax:305-456-3425
Practice Address - Street 1:2500 NW 79TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1003
Practice Address - Country:US
Practice Address - Phone:786-715-3883
Practice Address - Fax:305-456-3425
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 12874235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007137600Medicaid