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General NPI Number Information
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NPI Number | 1962635029
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Entity Type | Individual
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Provider Name | IDA ELDA VALERA SLP
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Gender | Female
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 14520 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33184-3132
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Country | US
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Telephone | 57-520-2203
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Fax |
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Provider Business Mailing Address
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Address Line | 3351 SW 139TH AVE
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City | MIAMI
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State | FL
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Zip | 33175-6705
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Country | US
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Telephone | 305-649-7050
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Fax | 305-649-3765
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SZ9470
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License Number State | FL
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