Provider Demographics
NPI:1053622282
Name:CORO-SANTOYO, LESLIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:CORO-SANTOYO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12030 SW 129TH CT STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4584
Mailing Address - Country:US
Mailing Address - Phone:786-390-6793
Mailing Address - Fax:786-375-5388
Practice Address - Street 1:12030 SW 129TH CT STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4584
Practice Address - Country:US
Practice Address - Phone:786-390-6793
Practice Address - Fax:786-375-5388
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5071235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist