Individual
MISS ASTRID BAVARESCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.A., M.S. CF-SLP
Contact information
Practice address
12595 SW 137TH AVE STE 305, MIAMI, FL 33186-4222
(786) 219-0151
Mailing address
12595 SW 137TH AVE STE 305, MIAMI, FL 33186-4222
(786) 219-0151
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA11547
FL
2355S0801X
Speech-Language Assistant
SI2555
FL
235Z00000X
Speech-Language Pathologist
Primary
SZ8926
FL
Other
Enumeration date
02/07/2013
Last updated
01/11/2019
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