Provider Demographics
NPI:1124200282
Name:TAPANES, MARLENE (ITDS, BS, SLP')
Entity Type:Individual
Prefix:MISS
First Name:MARLENE
Middle Name:
Last Name:TAPANES
Suffix:
Gender:F
Credentials:ITDS, BS, SLP'
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 SW 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3817
Mailing Address - Country:US
Mailing Address - Phone:305-281-3379
Mailing Address - Fax:305-225-0270
Practice Address - Street 1:4420 SW 135TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3817
Practice Address - Country:US
Practice Address - Phone:305-281-3379
Practice Address - Fax:305-225-0270
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 1242222Q00000X, 2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant