Provider Demographics
NPI:1629433990
Name:LANTIGUA, NETTIE
Entity type:Individual
Prefix:
First Name:NETTIE
Middle Name:
Last Name:LANTIGUA
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 1:16533 SW 50TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5174
Mailing Address - Country:US
Mailing Address - Phone:786-474-8345
Mailing Address - Fax:
Practice Address - Street 1:16533 SW 50TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5174
Practice Address - Country:US
Practice Address - Phone:786-474-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty