Provider Demographics
NPI:1760716930
Name:CIOCCA, MARIA VICTORIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:VICTORIA
Last Name:CIOCCA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 SW 138TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1251
Mailing Address - Country:US
Mailing Address - Phone:305-219-2087
Mailing Address - Fax:
Practice Address - Street 1:7650 SW 138TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1251
Practice Address - Country:US
Practice Address - Phone:305-219-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1760716930Medicaid