Provider Demographics
NPI:1194180620
Name:PIRES, FLAVIA TORQUATO
Entity Type:Individual
Prefix:MRS
First Name:FLAVIA
Middle Name:TORQUATO
Last Name:PIRES
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 1:3401 TALL TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-6062
Mailing Address - Country:US
Mailing Address - Phone:321-400-7535
Mailing Address - Fax:
Practice Address - Street 1:631 E OAK RIDGE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4266
Practice Address - Country:US
Practice Address - Phone:407-280-3776
Practice Address - Fax:407-517-4358
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 2416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist