Basic Information
| Provider Information | |||||||||
| NPI: | 1922524743 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAFFITTE LOPEZ | ||||||||
| FirstName: | DENISE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 335 S BISCAYNE BLVD APT 1610 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331312327 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8100 SW 10TH ST | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333243279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542101141 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2017 | ||||||||
| LastUpdateDate: | 09/01/2017 | ||||||||
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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 | 231H00000X | N | Speech, Language and Hearing Service Providers | Audiologist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 231H00000X | AY2146 | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.