Provider Demographics
NPI:1912202995
Name:VALDES, STEFANIE M (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:M
Last Name:VALDES
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ANTILLA AVE
Mailing Address - Street 2:#C
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3400
Mailing Address - Country:US
Mailing Address - Phone:786-368-8214
Mailing Address - Fax:
Practice Address - Street 1:11 ANTILLA AVE
Practice Address - Street 2:#C
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3400
Practice Address - Country:US
Practice Address - Phone:786-368-8214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6888235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist