Healthcare Provider Details

I. General information

NPI: 1609200864
Provider Name (Legal Business Name): DELIA RUANO-SIERRA M.S. SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DELIA RUANO

II. Dates (important events)

Enumeration Date: 08/23/2013
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10481 SW 202ND TER
CUTLER BAY FL
33189-1345
US

IV. Provider business mailing address

10481 SW 202ND TER
CUTLER BAY FL
33189-1345
US

V. Phone/Fax

Practice location:
  • Phone: 786-325-7823
  • Fax:
Mailing address:
  • Phone: 786-325-7823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA12222
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: