Provider Demographics
NPI:1386241354
Name:FALCONE, JUSTINA J (MSCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JUSTINA
Middle Name:J
Last Name:FALCONE
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 SW 15TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-1505
Mailing Address - Country:US
Mailing Address - Phone:239-482-5783
Mailing Address - Fax:
Practice Address - Street 1:3223 SW 15TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-1505
Practice Address - Country:US
Practice Address - Phone:239-482-5783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6846235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist