Healthcare Provider Details

I. General information

NPI: 1972280378
Provider Name (Legal Business Name): YAIMARA GUZMAN AMADOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2023
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SW 22ND ST STE 604
MIAMI FL
33145-2657
US

IV. Provider business mailing address

575 W 76TH ST
HIALEAH FL
33014-4203
US

V. Phone/Fax

Practice location:
  • Phone: 757-971-0808
  • Fax:
Mailing address:
  • Phone: 786-578-2373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI7957
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: