Organization
ADVANCE YOUR SPEECH, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LELLANY VIVANCO M.S. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST / OWNER)
(305) 602-8098
Entity
Organization
Contact information
Practice address
1405 SW 107TH AVE STE 301-H1, MIAMI, FL 33174-2533
(305) 602-8098
(305) 602-8208
Mailing address
1405 SW 107TH AVE STE 301-H1, MIAMI, FL 33174-2533
(305) 602-8098
(305) 602-8208
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002781500
—
FL
Enumeration date
05/13/2014
Last updated
07/11/2016
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