Provider Demographics
NPI:1982728341
Name:DUQUESNE, CORAL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CORAL
Middle Name:
Last Name:DUQUESNE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 SW 79 COURT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155
Mailing Address - Country:US
Mailing Address - Phone:305-984-8630
Mailing Address - Fax:305-261-5669
Practice Address - Street 1:7815 SW 24TH ST
Practice Address - Street 2:SUITE 109
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6541
Practice Address - Country:US
Practice Address - Phone:305-261-5664
Practice Address - Fax:305-261-5669
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist