Healthcare Provider Details

I. General information

NPI: 1972274090
Provider Name (Legal Business Name): MS. SHERLIE VANESSA PAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11601 BISCAYNE BLVD STE 312
MIAMI FL
33181-3151
US

IV. Provider business mailing address

4930 NW 4TH ST
MIAMI FL
33126-5106
US

V. Phone/Fax

Practice location:
  • Phone: 786-206-4151
  • Fax:
Mailing address:
  • Phone: 786-307-4495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA20902
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: