MEDICARE: ADVANCED THERAPY OF SOUTH FLORIDA LLC

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	235Z00000X	Speech-Language Pathologist
2	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619662327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED THERAPY OF SOUTH FLORIDA LLC

Provider Business Mailing Address
First Line	:	9399 NW 121ST TER
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4225
Country	:	US
Telephone Number	:	786-412-3162
Fax Number	:

Provider Business Practice Location Address
First Line	:	9399 NW 121ST TER
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4225
Country	:	US
Telephone Number	:	786-412-3162
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MELISSA SIERRA
Credential	:
Telephone Number	:	786-412-3162

Provider Enumeration Date	:	04/07/2023
Last Update Date	:	03/19/2025

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Directions to “ADVANCED THERAPY OF SOUTH FLORIDA LLC ” Practice Location

Language	Start Address	Practice Location

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