Provider Demographics
NPI:1164717872
Name:SANCHEZ RIVERA, DAMARIS
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:
Last Name:SANCHEZ RIVERA
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 1:22750 SW 92ND CT
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1485
Mailing Address - Country:US
Mailing Address - Phone:305-560-9294
Mailing Address - Fax:
Practice Address - Street 1:9425 SW 72ND ST STE 261
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5457
Practice Address - Country:US
Practice Address - Phone:305-271-7343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20763235Z00000X
FLSZ10264235Z00000X
222Q00000X
FLSI21822355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant