Provider Demographics
NPI:1205606993
Name:PEDRAJA, CAROLINA PINEIRO (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:PINEIRO
Last Name:PEDRAJA
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 1:13440 SW 62ND ST APT G101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5185
Mailing Address - Country:US
Mailing Address - Phone:786-514-1904
Mailing Address - Fax:
Practice Address - Street 1:1735 N TREASURE DR
Practice Address - Street 2:
Practice Address - City:NORTH BAY VILLAGE
Practice Address - State:FL
Practice Address - Zip Code:33141-4216
Practice Address - Country:US
Practice Address - Phone:305-865-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10842235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist