Provider Demographics
NPI:1548569635
Name:GEORGESCU, LUISA RAMONA
Entity Type:Individual
Prefix:MRS
First Name:LUISA
Middle Name:RAMONA
Last Name:GEORGESCU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 CYPRESS RD APT B17
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2373
Mailing Address - Country:US
Mailing Address - Phone:786-444-2218
Mailing Address - Fax:
Practice Address - Street 1:6901 CYPRESS RD APT B17
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2373
Practice Address - Country:US
Practice Address - Phone:786-444-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 12192355S0801X
FL56801103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant