Provider Demographics
NPI:1548454176
Name:CANGE, FITZ H (MSCCC-SLP)
Entity type:Individual
Prefix:MR
First Name:FITZ
Middle Name:H
Last Name:CANGE
Suffix:
Gender:M
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 SW 184TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5425
Mailing Address - Country:US
Mailing Address - Phone:954-822-4849
Mailing Address - Fax:954-438-9399
Practice Address - Street 1:3590 S STATE ROAD 7 STE 218
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5299
Practice Address - Country:US
Practice Address - Phone:954-822-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 4740235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist