Healthcare Provider Details

I. General information

NPI: 1710840277
Provider Name (Legal Business Name): MIRIAM PEREZ JUANES SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5035 NW 27TH AVE APT B
MIAMI FL
33142-3589
US

IV. Provider business mailing address

5035 NW 27TH AVE APT B
MIAMI FL
33142-3589
US

V. Phone/Fax

Practice location:
  • Phone: 786-771-6402
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI8103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: