Provider Demographics
NPI:1639446255
Name:SOUTH FLORIDA SPEECH SOLUTIONS
Entity Type:Organization
Organization Name:SOUTH FLORIDA SPEECH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:GRANDCHAMP-MILAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:305-962-4682
Mailing Address - Street 1:17034 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4539
Mailing Address - Country:US
Mailing Address - Phone:954-435-2286
Mailing Address - Fax:
Practice Address - Street 1:17034 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4539
Practice Address - Country:US
Practice Address - Phone:954-435-2286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10083261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech