Healthcare Provider Details

I. General information

NPI: 1902651367
Provider Name (Legal Business Name): GABRIELLA JENNIFER VAYSMAN CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GABRIELLA JENNIDER VAYSMAN CF-SLP

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12545 ORANGE DR STE 502
DAVIE FL
33330-4306
US

IV. Provider business mailing address

3101 S OCEAN DR APT 2108
HOLLYWOOD FL
33019-2836
US

V. Phone/Fax

Practice location:
  • Phone: 954-474-8145
  • Fax:
Mailing address:
  • Phone: 732-881-1426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number11885
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: