Healthcare Provider Details

I. General information

NPI: 1326697178
Provider Name (Legal Business Name): CAROLINE PLYAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 E HALLANDALE BEACH BLVD STE 3
HALLANDALE BEACH FL
33009-4488
US

IV. Provider business mailing address

19501 W COUNTRY CLUB DR APT 2606
AVENTURA FL
33180-2483
US

V. Phone/Fax

Practice location:
  • Phone: 954-458-5040
  • Fax:
Mailing address:
  • Phone: 514-730-0245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ9150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: