Organization
ADVANCE SPEECH THERAPY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY MARIE LUQUE M.S. CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST/PRES.)
(772) 336-6928
Entity
Organization
Contact information
Practice address
1483 SW BOUGAINVILLEA AVE, PORT SAINT LUCIE, FL 34953-7302
(772) 336-6928
(772) 336-6929
Mailing address
1483 SW BOUGAINVILLEA AVE, PORT SAINT LUCIE, FL 34953-7302
(772) 336-6928
(772) 336-6929
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114805100
—
FL
Enumeration date
04/23/2007
Last updated
01/27/2026
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