Individual
CLARA ROSA MORA BLAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
11747 SW 99TH LN, MIAMI, FL 33186-2752
(786) 424-0936
Mailing address
11747 SW 99TH LN, MIAMI, FL 33186-2752
(786) 424-0936
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
FL
235Z00000X
Speech-Language Pathologist
Primary
SA20817
FL
Other
Enumeration date
04/02/2018
Last updated
09/26/2022
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