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Organization
COASTAL DYSPHAGIA SOLUTIONS INC
Active
Organization
COASTAL DYSPHAGIA SOLUTIONS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VANESSA MARTINEZ MS, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST/OWNER)
(239) 763-0353
Entity
Organization
Contact information
Practice address
520 SW 15TH ST, CAPE CORAL, FL 33991-2736
(239) 763-0353
Mailing address
1242 SW PINE ISLAND RD, STE 42 #441, CAPE CORAL, FL 33991
(239) 763-0353
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
261QE0800X
Endoscopy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134439805
—
FL
Enumeration date
07/20/2023
Last updated
07/20/2023
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