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General NPI Number Information
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NPI Number | 1114294915
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Entity Type | Organization
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Legal Business Name | NOREDYS SIRE CORP
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 6858 SW 158TH PASS
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City | MIAMI
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State | FL
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Zip | 33193-3613
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Country | US
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Telephone | 305-382-7073
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Fax |
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Provider Business Mailing Address
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Address Line | 6858 SW 158TH PASS
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City | MIAMI
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State | FL
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Zip | 33193-3613
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Country | US
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Telephone | 305-382-7073
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. NOREDYS MARIA SIRE
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Credential |
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Telephone | 305-382-7073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SZ 5056
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License Number State | FL
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