Healthcare Provider Details

I. General information

NPI: 1609731041
Provider Name (Legal Business Name): MARIA DRESERIS SLP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MARIA. DRESERIS
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 786-514-2345