Basic Information
| Provider Information | |||||||||
| NPI: | 1447358346 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAGUSA | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19641 SW 79TH PL | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331892150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052525565 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11440 N KENDALL DR STE 109 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331761024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059298705 | ||||||||
| FaxNumber: | 3056003714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 11/01/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SA6763 | FL | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 222Q00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
ID Information
| ID | Type | State | Issuer | Description | 811394700 | 05 | FL | MEDICAID | 888100600 | 05 | FL | MEDICAID |