Healthcare Provider Details

I. General information

NPI: 1629953252
Provider Name (Legal Business Name): JANNABEL PATRICE AMEEN M.S., CCC - SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4960 SW 72ND AVE STE 210
MIAMI FL
33155-5549
US

IV. Provider business mailing address

4960 SW 72ND AVE STE 210
MIAMI FL
33155-5549
US

V. Phone/Fax

Practice location:
  • Phone: 305-461-4702
  • Fax: 305-461-4702
Mailing address:
  • Phone: 305-461-4702
  • Fax: 305-461-4702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA25044
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ12811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: