Provider Demographics
NPI:1669207650
Name:CECILIO, RANDI HOPE (SLP)
Entity type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:HOPE
Last Name:CECILIO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 NEW BROAD CIR APT 108
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7383
Mailing Address - Country:US
Mailing Address - Phone:407-325-2582
Mailing Address - Fax:
Practice Address - Street 1:395 ALAFAYA WOODS BLVD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7095
Practice Address - Country:US
Practice Address - Phone:407-542-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist