Provider Demographics
NPI:1811121882
Name:MAURICIO, MARIA CECILIA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CECILIA
Last Name:MAURICIO
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Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5190 NW 167TH ST
Mailing Address - Street 2:SUITE 117
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6328
Mailing Address - Country:US
Mailing Address - Phone:954-868-3088
Mailing Address - Fax:954-484-7235
Practice Address - Street 1:5190 NW 167TH ST
Practice Address - Street 2:SUITE 117
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33014-6328
Practice Address - Country:US
Practice Address - Phone:954-868-3088
Practice Address - Fax:954-484-7235
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSA 10125235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist