Provider Demographics
NPI:1164145181
Name:MEULENER, GENEIA FANTAUZZI
Entity Type:Individual
Prefix:MRS
First Name:GENEIA
Middle Name:FANTAUZZI
Last Name:MEULENER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 NW 33RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5491
Mailing Address - Country:US
Mailing Address - Phone:305-510-7388
Mailing Address - Fax:
Practice Address - Street 1:2029 NW 33RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5491
Practice Address - Country:US
Practice Address - Phone:305-510-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI58922355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant