Provider Demographics
NPI:1255729067
Name:PIZARRO, TATIANA
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:PIZARRO
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 1:4650 NW 107TH AVE APT 1809
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4257
Mailing Address - Country:US
Mailing Address - Phone:305-994-4505
Mailing Address - Fax:
Practice Address - Street 1:4650 NW 107TH AVE APT 1809
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4257
Practice Address - Country:US
Practice Address - Phone:305-994-4505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI24562355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant