Provider Demographics
NPI:1417625849
Name:ROSARIO SPEECH LANGUAGE THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:ROSARIO SPEECH LANGUAGE THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SULTANA
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:646-515-1455
Mailing Address - Street 1:88 ROXBORO DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-6920
Mailing Address - Country:US
Mailing Address - Phone:646-515-1455
Mailing Address - Fax:
Practice Address - Street 1:88 ROXBORO DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-6920
Practice Address - Country:US
Practice Address - Phone:646-515-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA18891OtherPROFESSIONAL STATE LICENSURE