| Doctor Name: | MICHELE DOMINGUEZ LEON |
| NPI Number: | 1205162971 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 10153 |
| Business Practice Address: | 17670 Nw 78th Ave Suite 113 Hialeah, FL - 330153664 |
| Business Phone Number: | 3055125757 |
| Business Fax Number: | 3055125755 |
| Mailing Address: | 4921 Sw 151st Ter, MIRAMAR |
| State: | FL |
| Postal Code: | 330273621 |
| Phone Number: | 9548545369 |
| Fax Number: | |
| NPI Enumeration Date: | 10/30/2009 |
| NPI Last Update Date: | 06/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 10153 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |