Provider Demographics
NPI:1487843785
Name:LUBIAN, SUZETTE MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:MARIE
Last Name:LUBIAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9350 SW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6522
Mailing Address - Country:US
Mailing Address - Phone:305-302-6656
Mailing Address - Fax:305-595-6657
Practice Address - Street 1:9350 SW 53RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-6522
Practice Address - Country:US
Practice Address - Phone:305-302-6656
Practice Address - Fax:305-595-6657
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist