Provider Demographics
NPI:1134547110
Name:YELITZA I. RUIZ AHORRIO SPEECH & LANGUAGE THERAPY, LLC.
Entity type:Organization
Organization Name:YELITZA I. RUIZ AHORRIO SPEECH & LANGUAGE THERAPY, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:YELITZA
Authorized Official - Middle Name:I
Authorized Official - Last Name:RUIZ AHORRIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:407-463-5300
Mailing Address - Street 1:14124 QUEENSIDE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4258
Mailing Address - Country:US
Mailing Address - Phone:407-463-5300
Mailing Address - Fax:
Practice Address - Street 1:1633 E VINE ST STE 213
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3705
Practice Address - Country:US
Practice Address - Phone:407-588-7776
Practice Address - Fax:407-588-9525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111112900Medicaid