Healthcare Provider Details

I. General information

NPI: 1497271530
Provider Name (Legal Business Name): JENNY M SOAREZ TUCEN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10794 SW 24TH ST
MIAMI FL
33165-2499
US

IV. Provider business mailing address

5250 NW 84TH AVE APT 1601
DORAL FL
33166-5387
US

V. Phone/Fax

Practice location:
  • Phone: 786-237-1483
  • Fax:
Mailing address:
  • Phone: 305-775-7749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA23621
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-39102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: