Provider Demographics
NPI:1386046183
Name:PARRA, EVELYN MARIE (MS)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:MARIE
Last Name:PARRA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2272 NW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2414
Mailing Address - Country:US
Mailing Address - Phone:305-733-3405
Mailing Address - Fax:305-640-8887
Practice Address - Street 1:11741 SW 110TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-3927
Practice Address - Country:US
Practice Address - Phone:305-733-3405
Practice Address - Fax:305-640-8887
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 6864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist