Provider Demographics
NPI:1720216351
Name:ADRIANZEN, BRENDA (SLP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:ADRIANZEN
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 1:4803 NW 7TH ST
Mailing Address - Street 2:206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2100
Mailing Address - Country:US
Mailing Address - Phone:305-776-9356
Mailing Address - Fax:305-228-6251
Practice Address - Street 1:4803 NW 7TH ST
Practice Address - Street 2:206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2100
Practice Address - Country:US
Practice Address - Phone:305-776-9356
Practice Address - Fax:305-228-6251
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist