Individual
DAISELY BASULTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C-SLPA
Contact information
Practice address
13155 SW 134TH ST STE 207, MIAMI, FL 33186-4488
(786) 842-3624
Mailing address
14511 SW 142ND PL, MIAMI, FL 33186-7202
(786) 603-6089
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SI5396
FL
235Z00000X
Speech-Language Pathologist
Primary
SZ10812
FL
Other
Enumeration date
05/27/2022
Last updated
12/05/2022
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