Provider Demographics
NPI:1407312275
Name:CUERVO, JENNIFER ANNE BERRE (SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE BERRE
Last Name:CUERVO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 CATALONIA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6303
Mailing Address - Country:US
Mailing Address - Phone:305-496-6437
Mailing Address - Fax:
Practice Address - Street 1:1018 CATALONIA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6303
Practice Address - Country:US
Practice Address - Phone:305-496-6437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-15
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8947235Z00000X
FLSA17927235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist