Healthcare Provider Details

I. General information

NPI: 1891862108
Provider Name (Legal Business Name): ERIKA BRAGA OLMEDO M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 COLLINS AVE APT 707
MIAMI BEACH FL
33141-2939
US

IV. Provider business mailing address

7600 COLLINS AVE APT 707
MIAMI BEACH FL
33141-2939
US

V. Phone/Fax

Practice location:
  • Phone: 305-993-0054
  • Fax:
Mailing address:
  • Phone: 305-993-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 7742
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: