Provider Demographics
NPI:1760743603
Name:PAZ, KARYN DETRICK (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:DETRICK
Last Name:PAZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 S BAYSHORE DR
Mailing Address - Street 2:APT 14E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1393 SW 1ST ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2321
Practice Address - Country:US
Practice Address - Phone:305-541-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 5364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist