MEDICARE: SOFIA CERVERA GARCIA

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	106S00000X	Behavior Technician
2	235Z00000X	Speech-Language Pathologist	SZ11210	FL
3	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1689196487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOFIA CERVERA GARCIA

Provider Business Mailing Address
First Line	:	16341 SW 114TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33157-2747
Country	:	US
Telephone Number	:	305-587-8884
Fax Number	:

Provider Business Practice Location Address
First Line	:	16341 SW 114TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33157-2747
Country	:	US
Telephone Number	:	305-587-8884
Fax Number	:

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

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	05/25/2023

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Directions to “ SOFIA CERVERA GARCIA ” Practice Location

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