Provider Demographics
NPI:1508583634
Name:CURBELO PANTOJA, TATIANA ESTHER (SLP)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:ESTHER
Last Name:CURBELO PANTOJA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NW 13TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1607
Mailing Address - Country:US
Mailing Address - Phone:305-545-2119
Mailing Address - Fax:305-548-3825
Practice Address - Street 1:1601 NW 13TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1607
Practice Address - Country:US
Practice Address - Phone:305-545-2119
Practice Address - Fax:305-548-3825
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist