Provider Demographics
NPI:1457014268
Name:THE ART OF SPEECH THERAPY SERVICES CORP
Entity Type:Organization
Organization Name:THE ART OF SPEECH THERAPY SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:DE LA CARIDAD
Authorized Official - Last Name:FRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:786-477-9617
Mailing Address - Street 1:13070 SW 265TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7818
Mailing Address - Country:US
Mailing Address - Phone:786-477-9617
Mailing Address - Fax:
Practice Address - Street 1:13070 SW 265TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-7818
Practice Address - Country:US
Practice Address - Phone:786-477-9617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1048581000Medicaid