Provider Demographics
NPI:1356126684
Name:NOGUERA, GLORIMAR (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:GLORIMAR
Middle Name:
Last Name:NOGUERA
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:ALTS DE HATO NUEVO 454
Mailing Address - Street 2:CALLE RIO LOCO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-8458
Mailing Address - Country:US
Mailing Address - Phone:787-321-0760
Mailing Address - Fax:
Practice Address - Street 1:1441 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2202
Practice Address - Country:US
Practice Address - Phone:305-541-3400
Practice Address - Fax:305-541-3344
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI65562355S0801X
FLSA22894235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant