Basic Information
| Provider Information | |||||||||
| NPI: | 1265982847 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALESTINA | ||||||||
| FirstName: | ADRIANNA | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 540 NW 165TH ST STE 111 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331696304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866234053 | ||||||||
| FaxNumber: | 7865240250 | ||||||||
| Practice Location | |||||||||
| Address1: | 8362 PINES BLVD | ||||||||
| Address2: | SUITE 119 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330246600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866234053 | ||||||||
| FaxNumber: | 7865240250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2016 | ||||||||
| LastUpdateDate: | 10/07/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SZ7889 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.