Provider Demographics
NPI:1174104814
Name:ISPEECH THERAPY GROUP INC
Entity type:Organization
Organization Name:ISPEECH THERAPY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:MARIUSKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-514-1475
Mailing Address - Street 1:14588 SW 158TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6782
Mailing Address - Country:US
Mailing Address - Phone:786-514-1475
Mailing Address - Fax:
Practice Address - Street 1:14588 SW 158TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6782
Practice Address - Country:US
Practice Address - Phone:786-514-1475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center