Provider Demographics
NPI:1396934279
Name:PEDIATRIC CENTER FOR COMMUNICATION & FEEDING DEFICIENCIES,INC.
Entity type:Organization
Organization Name:PEDIATRIC CENTER FOR COMMUNICATION & FEEDING DEFICIENCIES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIATERESA (TERI)
Authorized Official - Middle Name:HERNANDEZ
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:305-598-5589
Mailing Address - Street 1:10300 SUNSET DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10300 SUNSET DR
Practice Address - Street 2:SUITE 280
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3012
Practice Address - Country:US
Practice Address - Phone:305-598-5589
Practice Address - Fax:305-598-5477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty