Provider Demographics
NPI:1932607462
Name:RODRIGUEZ AGRAMONTE, DINA P (SLP)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:P
Last Name:RODRIGUEZ AGRAMONTE
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 1:60 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4328
Mailing Address - Country:US
Mailing Address - Phone:917-622-5417
Mailing Address - Fax:
Practice Address - Street 1:60 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-4328
Practice Address - Country:US
Practice Address - Phone:917-622-5417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty