MEDICARE: ADA537 SPEECH LANGUGUE PATHOLOGY INC

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

General Provider Information

NPI Number	:	1538094305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADA537 SPEECH LANGUGUE PATHOLOGY INC

Provider Business Mailing Address
First Line	:	14902 SW 173RD TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-6756
Country	:	US
Telephone Number	:	305-281-5408
Fax Number	:	305-281-5408

Provider Business Practice Location Address
First Line	:	14902 SW 173RD TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33187-6756
Country	:	US
Telephone Number	:	305-281-5408
Fax Number	:	305-281-5408

Authorized Official
Title or Position	:	CFY SLP
Name	:	IRACEMA DIAZ
Credential	:
Telephone Number	:	305-281-5408

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/16/2026

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