Healthcare Provider Details

I. General information

NPI: 1346085271
Provider Name (Legal Business Name): SARAH FISKE LEDERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 WEST AVE APT 706
MIAMI BEACH FL
33139-0903
US

IV. Provider business mailing address

6100 HOLLYWOOD BLVD STE 305
PEMBROKE PINES FL
33024-7981
US

V. Phone/Fax

Practice location:
  • Phone: 305-467-3005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22467
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number032745
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: