Provider Demographics
NPI:1740459528
Name:TORMO, MARIA DEL PILAR
Entity type:Individual
Prefix:
First Name:MARIA DEL PILAR
Middle Name:
Last Name:TORMO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA DEL PILAR
Other - Middle Name:
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12516 SW 124TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5421
Mailing Address - Country:US
Mailing Address - Phone:305-562-0598
Mailing Address - Fax:
Practice Address - Street 1:12516 SW 124TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5421
Practice Address - Country:US
Practice Address - Phone:305-562-0598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 11963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL892647600Medicaid