Basic Information
| Provider Information | |||||||||
| NPI: | 1467989764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARDONA | ||||||||
| FirstName: | KATIA | ||||||||
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| Credential: | M.S CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18115 N US HIGHWAY 41 STE 800 | ||||||||
| Address2: | |||||||||
| City: | LUTZ | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335496475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138480341 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 N REO ST | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336091061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8133742070 | ||||||||
| FaxNumber: | 8133370937 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2017 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 235Z00000X | SZ10058 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.