Provider Demographics
NPI:1609064476
Name:COLOME, NOEMI (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:NOEMI
Middle Name:
Last Name:COLOME
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14195 SW 155TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6057
Mailing Address - Country:US
Mailing Address - Phone:786-301-4039
Mailing Address - Fax:
Practice Address - Street 1:14195 SW 155TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6057
Practice Address - Country:US
Practice Address - Phone:786-301-4039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5832235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12002810OtherASHA CERTIFICATION
FLSA 5832OtherFL DEPT. OF HEALTH