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Individual

MIRELLY ALICEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11320 SW 245TH ST, HOMESTEAD, FL 33032-4637
(786) 556-0478
Mailing address
13989 SW 160TH CT, MIAMI, FL 33196-6500

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI3451

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SI3451
FL LICENSE
Enumeration date
01/19/2018
Last updated
01/19/2018
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