MEDICARE: CASSANDRA S BAEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SI4587	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SI4587	OTHER	FL	SPEECH LANGUAGE PATHOLOGY ASSISTANT

General Provider Information

NPI Number	:	1366191884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA S BAEZ

Provider Business Mailing Address
First Line	:	1243 SW 46TH AVE APT 1110
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-0922
Country	:	US
Telephone Number	:	786-368-7411
Fax Number	:

Provider Business Practice Location Address
First Line	:	3891 STIRLING RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-6216
Country	:	US
Telephone Number	:	954-416-2444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	04/21/2022

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Directions to “ CASSANDRA S BAEZ ” Practice Location

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