Healthcare Provider Details

I. General information

NPI: 1538094305
Provider Name (Legal Business Name): ADA537 SPEECH LANGUGUE PATHOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14902 SW 173RD TER
MIAMI FL
33187-6756
US

IV. Provider business mailing address

14902 SW 173RD TER
MIAMI FL
33187-6756
US

V. Phone/Fax

Practice location:
  • Phone: 305-281-5408
  • Fax: 305-281-5408
Mailing address:
  • Phone: 305-281-5408
  • Fax: 305-281-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: IRACEMA DIAZ
Title or Position: CFY SLP
Credential:
Phone: 305-281-5408