Doctor Name: | MRS. LOURDES IRENE CARVAJAL |
NPI Number: | 1295967883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | S.L.P. |
License Number: | SA 10702 |
Business Practice Address: | 9164 Nw 149th Ter Miami Lakes, FL - 330188058 |
Business Phone Number: | 3053316126 |
Business Fax Number: | 3055561007 |
Mailing Address: | 9164 Nw 149th Ter, MIAMI LAKES |
State: | FL |
Postal Code: | 330188058 |
Phone Number: | 3053316126 |
Fax Number: | 3055561007 |
NPI Enumeration Date: | 08/14/2009 |
NPI Last Update Date: | 10/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 10702 |
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 |