MEDICARE: MS. THAIZ PULIDO MS. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA24116	FL

General Provider Information

NPI Number	:	1295699148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. THAIZ PULIDO MS. CCC-SLP

Provider Business Mailing Address
First Line	:	6240 NW 173RD ST APT 1030
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-4561
Country	:	US
Telephone Number	:	786-280-3307
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 E 5TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4892
Country	:	US
Telephone Number	:	305-885-4556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ MS. THAIZ PULIDO MS. CCC-SLP” Practice Location

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