Organization Name: | FERNANDO COSTAS |
NPI Number: | 1780043679 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FERNANDO COSTAS (SPEECH AND LANGUAGE PATHOLOGIST) |
Mailing Address: | 7 Carr 877 # Km Marginal Trujillo Alto San Juan |
State: | PR US |
Postal Code: | 009268212 |
Phone Number: | 9392048074 |
Fax Number: | |
NPI Enumeration Date: | 02/19/2016 |
NPI Last Update Date: | 02/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1086 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
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 |