Healthcare Provider Details

I. General information

NPI: 1134691827
Provider Name (Legal Business Name): MARIA DRESERIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 NW 59TH AVE
VIRGINIA GARDENS FL
33166-5740
US

IV. Provider business mailing address

3940 NW 59TH AVE
VIRGINIA GARDENS FL
33166-5740
US

V. Phone/Fax

Practice location:
  • Phone: 786-514-2345
  • Fax:
Mailing address:
  • Phone: 786-514-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA18337
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: