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Organization
MST KIDS LLC
Active
Organization
MST KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELLA GALLEGO (SPEECH PATHOLOGIST)
(305) 283-5884
Entity
Organization
Contact information
Practice address
12030 SW 123RD TER, MIAMI, FL 33186-5156
(305) 283-5884
Mailing address
12030 SW 123RD TER, MIAMI, FL 33186-5156
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA11674
FL
Other
Enumeration date
12/09/2016
Last updated
12/09/2016
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