Healthcare Provider Details

I. General information

NPI: 1053054411
Provider Name (Legal Business Name): CHRISTINE MICHELLE SAENZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12485 SW 137TH AVE
MIAMI FL
33186-4216
US

IV. Provider business mailing address

12039 SW 110TH STREET CIR S
MIAMI FL
33186-3829
US

V. Phone/Fax

Practice location:
  • Phone: 786-732-4922
  • Fax:
Mailing address:
  • Phone: 786-457-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI4672
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: