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General NPI Number Information
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NPI Number | 1639501463
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Entity Type | Individual
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Provider Name | KAYLA ERTTER
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Gender | Female
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Dates
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Enumeration Date | 08/03/2013
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 20197 NE 16TH PLACE SECOND FLOOR
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City | NORTH MIAMI
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State | FL
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Zip | 33141
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Country | US
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Telephone | 201-400-9029
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S BISCAYNE BLVD APT 426
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City | MIAMI
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State | FL
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Zip | 33131-5315
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Country | US
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Telephone | 814-242-2739
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA14549
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License Number State | FL
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