Provider Demographics
NPI:1114494788
Name:SPEECH AND LANGUAGE CENTER OF SOUTH FLORIDA, LLC
Entity Type:Organization
Organization Name:SPEECH AND LANGUAGE CENTER OF SOUTH FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHWALD
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:305-785-2555
Mailing Address - Street 1:19360 NE 22ND RD
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3619
Mailing Address - Country:US
Mailing Address - Phone:305-785-2555
Mailing Address - Fax:
Practice Address - Street 1:19360 NE 22ND RD
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-3619
Practice Address - Country:US
Practice Address - Phone:305-785-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center