Provider Demographics
NPI:1467849265
Name:RISCIGNO, MIOSOTIS (MS, SLP)
Entity Type:Individual
Prefix:
First Name:MIOSOTIS
Middle Name:
Last Name:RISCIGNO
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 TAFT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-4256
Mailing Address - Country:US
Mailing Address - Phone:305-450-1719
Mailing Address - Fax:
Practice Address - Street 1:4116 TAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-4256
Practice Address - Country:US
Practice Address - Phone:305-450-1719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist