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Individual

ANTONIETTA LUCIA MASTROTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S, CF-SLP

Contact information

Practice address
2957 W STATE ROAD 434 STE 100, LONGWOOD, FL 32779-4453
(407) 960-4049
Mailing address
304 LAKE AVE APT 329, MAITLAND, FL 32751-6393

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ8796
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
FD337Z
FL
01
SZ8796
FL DEPARTMENT OF HEALTH
FL
Enumeration date
09/19/2018
Last updated
10/02/2018
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