Provider Demographics
NPI:1790117240
Name:AMAZING SPEECH LLC
Entity Type:Organization
Organization Name:AMAZING SPEECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANALIA
Authorized Official - Middle Name:FERNANDA
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC
Authorized Official - Phone:786-423-2423
Mailing Address - Street 1:14286 SW 122ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6028
Mailing Address - Country:US
Mailing Address - Phone:786-423-2423
Mailing Address - Fax:
Practice Address - Street 1:14286 SW 122ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6028
Practice Address - Country:US
Practice Address - Phone:786-423-2423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11848235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty