Provider Demographics
NPI:1548494172
Name:RUIZ JUNCO, ESPERANZA
Entity type:Individual
Prefix:
First Name:ESPERANZA
Middle Name:
Last Name:RUIZ JUNCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 S PALM AIRE DR APT 609
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-4213
Mailing Address - Country:US
Mailing Address - Phone:631-455-2757
Mailing Address - Fax:754-800-2719
Practice Address - Street 1:2901 S PALM AIRE DR APT 609
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4213
Practice Address - Country:US
Practice Address - Phone:631-455-2757
Practice Address - Fax:754-800-2719
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018813-1235Z00000X
FL18893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist