Provider Demographics
NPI:1063803211
Name:JAMES, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4131
Mailing Address - Country:US
Mailing Address - Phone:305-904-1986
Mailing Address - Fax:
Practice Address - Street 1:1560 NW 129TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-2242
Practice Address - Country:US
Practice Address - Phone:305-904-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA18750235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18750OtherFLORIDA DEPARTMENT OF HEALTH
FL18750OtherFLORIDA DEPARTMENT OF HEALTH