Provider Demographics
NPI:1649674102
Name:ESTEVEZ S.L.P & ASSOCIATES, INC
Entity type:Organization
Organization Name:ESTEVEZ S.L.P & ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MIRKA
Authorized Official - Middle Name:FREIRE
Authorized Official - Last Name:ESTEVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:786-586-4856
Mailing Address - Street 1:18191 NW 68TH AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3996
Mailing Address - Country:US
Mailing Address - Phone:305-558-4646
Mailing Address - Fax:305-558-4649
Practice Address - Street 1:18191 NW 68TH AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3996
Practice Address - Country:US
Practice Address - Phone:305-558-4646
Practice Address - Fax:305-558-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8455235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890599100Medicaid