=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174204150
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPEAK ELEMENTS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2023
-----------------------------------------------------
Last Update Date | 02/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14040 NE 9TH AVE
-----------------------------------------------------
City | NORTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33161-3265
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-530-5503
-----------------------------------------------------
Fax | 786-435-0606
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1801 NE 123RD ST STE 314
-----------------------------------------------------
City | NORTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33181-2883
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-530-5503
-----------------------------------------------------
Fax | 786-435-0606
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH-LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | SASHA JEAN TORCHENAUD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-730-2150
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------