Provider Demographics
NPI:1851700579
Name:LEAL, CHRISTINE GUAYARA
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:GUAYARA
Last Name:LEAL
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 1:3705 HERTFORD CT
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3041
Mailing Address - Country:US
Mailing Address - Phone:561-602-5844
Mailing Address - Fax:
Practice Address - Street 1:3705 HERTFORD CT
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3041
Practice Address - Country:US
Practice Address - Phone:561-602-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist