Provider Demographics
NPI:1134481302
Name:PIEDRAHITA, RUTH P (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:P
Last Name:PIEDRAHITA
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 1:7335 NW 173RD DR APT 101
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-8418
Mailing Address - Country:US
Mailing Address - Phone:786-536-0669
Mailing Address - Fax:
Practice Address - Street 1:7335 NW 173RD DR APT 101
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-8418
Practice Address - Country:US
Practice Address - Phone:786-536-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI2114222Q00000X, 252Y00000X
235Z00000X
FLSA20784235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007247701Medicaid
FL007247700Medicaid