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Individual

BRENDA IVELISSE COLON COLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS SLP

Contact information

Practice address
7875 NW 11TH ST, PLANTATION, FL 33322-5155
(787) 358-3790
Mailing address
7875 NW 11TH ST, PLANTATION, FL 33322-5155
(787) 358-3790

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
3000
PR
235Z00000X
Speech-Language Pathologist
Primary
SA16118
FL

Other

Enumeration date
12/18/2014
Last updated
09/16/2020
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