Doctor Name: | KRYSTINA MANTZOURANIS |
NPI Number: | 1003274481 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 107 Antilla Ave Coral Gables, FL - 331343301 |
Business Phone Number: | 3055675881 |
Business Fax Number: | |
Mailing Address: | 107 Antilla Ave, CORAL GABLES |
State: | FL |
Postal Code: | 331343301 |
Phone Number: | 3055675881 |
Fax Number: | |
NPI Enumeration Date: | 02/01/2016 |
NPI Last Update Date: | 02/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |