Provider Demographics
NPI:1508221920
Name:SPEECH AND LANGUAGE CONNECTION SERVICES, LLC
Entity Type:Organization
Organization Name:SPEECH AND LANGUAGE CONNECTION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:AGUERO
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:305-218-5020
Mailing Address - Street 1:17240 NW 74TH PATH
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-7111
Mailing Address - Country:US
Mailing Address - Phone:305-218-5020
Mailing Address - Fax:
Practice Address - Street 1:17240 NW 74TH PATH
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-7111
Practice Address - Country:US
Practice Address - Phone:305-218-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 14142235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty