Provider Demographics
NPI:1528340577
Name:VALCARCEL, JOHANNIE (MS)
Entity type:Individual
Prefix:
First Name:JOHANNIE
Middle Name:
Last Name:VALCARCEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 SW 1ST AVE
Mailing Address - Street 2:APT 1207
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1179
Mailing Address - Country:US
Mailing Address - Phone:787-225-8205
Mailing Address - Fax:
Practice Address - Street 1:1818 SW 1ST AVE
Practice Address - Street 2:APT 1207
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-1179
Practice Address - Country:US
Practice Address - Phone:787-225-8205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist