Healthcare Provider Details

I. General information

NPI: 1063324242
Provider Name (Legal Business Name): VERONICA PITA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 NW 25TH ST STE A-108
DORAL FL
33172-5921
US

IV. Provider business mailing address

10200 NW 25TH ST STE A-108
DORAL FL
33172-5921
US

V. Phone/Fax

Practice location:
  • Phone: 786-717-5649
  • Fax:
Mailing address:
  • Phone: 786-717-5649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number8686
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: