Provider Demographics
NPI:1164159356
Name:PASZTERNAK, CARA MIA
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:MIA
Last Name:PASZTERNAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:MIA
Other - Last Name:BRUEGGEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BRUEGGEMAN
Mailing Address - Street 1:626 PERSIAN DR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-8381
Mailing Address - Country:US
Mailing Address - Phone:772-766-1322
Mailing Address - Fax:
Practice Address - Street 1:1218 SHORECREST CIR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2942
Practice Address - Country:US
Practice Address - Phone:407-732-8136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22363235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist