Provider Demographics
NPI:1316071897
Name:BIANCO, CHARLOTTE BARTOW (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:BARTOW
Last Name:BIANCO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NATURES WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-7808
Mailing Address - Country:US
Mailing Address - Phone:561-895-0215
Mailing Address - Fax:
Practice Address - Street 1:2904 S JOG RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2002
Practice Address - Country:US
Practice Address - Phone:561-557-9479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7731235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890560600Medicaid