Provider Demographics
NPI:1821446949
Name:MARRON, JENNIFER YANIRE
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:YANIRE
Last Name:MARRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2735 W 68TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5477
Mailing Address - Country:US
Mailing Address - Phone:786-942-4400
Mailing Address - Fax:
Practice Address - Street 1:9425 SW 72ND ST STE 261
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5457
Practice Address - Country:US
Practice Address - Phone:305-271-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI28692355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant