Provider Demographics
NPI:1518593573
Name:SPEECH THERAPY MIAMI LLC
Entity Type:Organization
Organization Name:SPEECH THERAPY MIAMI LLC
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINICAL DIRECTOR/SLP
Authorized Official - Prefix:
Authorized Official - First Name:ADALYS
Authorized Official - Middle Name:
Authorized Official - Last Name:IGLESIAS RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:305-873-9589
Mailing Address - Street 1:1301 SW 138TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2761
Mailing Address - Country:US
Mailing Address - Phone:305-873-9589
Mailing Address - Fax:
Practice Address - Street 1:9106 NW 120TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4178
Practice Address - Country:US
Practice Address - Phone:305-873-9589
Practice Address - Fax:305-397-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty