Provider Demographics
NPI:1578863056
Name:VITON-MARTINEZ, YUSIMIR (SLP A)
Entity Type:Individual
Prefix:MRS
First Name:YUSIMIR
Middle Name:
Last Name:VITON-MARTINEZ
Suffix:
Gender:F
Credentials:SLP A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MIRACLE MILE STE 403
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4926
Mailing Address - Country:US
Mailing Address - Phone:305-446-1098
Mailing Address - Fax:305-446-1638
Practice Address - Street 1:401 MIRACLE MILE STE 403
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4926
Practice Address - Country:US
Practice Address - Phone:305-446-1098
Practice Address - Fax:305-446-1638
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI15032355A2700X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant