Provider Demographics
NPI:1891862108
Name:OLMEDO, ERIKA BRAGA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:BRAGA
Last Name:OLMEDO
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 1:7600 COLLINS AVE APT 707
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-2939
Mailing Address - Country:US
Mailing Address - Phone:305-993-0054
Mailing Address - Fax:
Practice Address - Street 1:7600 COLLINS AVE APT 707
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2939
Practice Address - Country:US
Practice Address - Phone:305-993-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7742235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist