Provider Demographics
NPI:1780022160
Name:MIRANDA BENDEZU, ESTHER M (MS; CCC-SLP; TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:M
Last Name:MIRANDA BENDEZU
Suffix:
Gender:F
Credentials:MS; CCC-SLP; TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 WHISPERING MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6706
Mailing Address - Country:US
Mailing Address - Phone:914-343-0133
Mailing Address - Fax:914-455-0158
Practice Address - Street 1:2309 WHISPERING MAPLE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6706
Practice Address - Country:US
Practice Address - Phone:914-343-0133
Practice Address - Fax:914-455-0158
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021488235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03652357Medicaid
FL110841000Medicaid