Provider Demographics
NPI:1083990758
Name:BALLESTER, CARIDAD I (BA SLP-A)
Entity Type:Individual
Prefix:MS
First Name:CARIDAD
Middle Name:I
Last Name:BALLESTER
Suffix:
Gender:F
Credentials:BA SLP-A
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Mailing Address - Street 1:15620 SW 152ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-5434
Mailing Address - Country:US
Mailing Address - Phone:786-351-2888
Mailing Address - Fax:305-232-2146
Practice Address - Street 1:15620 SW 152ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-5434
Practice Address - Country:US
Practice Address - Phone:786-351-2888
Practice Address - Fax:305-232-2146
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant