Provider Demographics
NPI:1588497572
Name:CANTOS MENDOZA, DANIELA SOFIA (CF SLP)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:SOFIA
Last Name:CANTOS MENDOZA
Suffix:
Gender:F
Credentials:CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3898 VIA POINCIANA STE 17
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2951
Mailing Address - Country:US
Mailing Address - Phone:561-376-2573
Mailing Address - Fax:
Practice Address - Street 1:3898 VIA POINCIANA STE 17
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2951
Practice Address - Country:US
Practice Address - Phone:561-376-2573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist