Individual
DIANELIS AVILA CABALLERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
15291 NW 60TH AVE STE 101, MIAMI LAKES, FL 33014-2459
(786) 385-1703
Mailing address
15291 NW 60TH AVE STE 101, MIAMI LAKES, FL 33014-2459
(786) 385-1703
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA17919
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100852700
—
FL
Enumeration date
09/10/2018
Last updated
05/14/2020
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