Provider Demographics
NPI:1073300992
Name:PORTAL, NORMA (SLPA)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:PORTAL
Suffix:
Gender:
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12775 SW 45 LANE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-4660
Mailing Address - Country:US
Mailing Address - Phone:786-447-7497
Mailing Address - Fax:
Practice Address - Street 1:2400 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6311
Practice Address - Country:US
Practice Address - Phone:305-456-0572
Practice Address - Fax:786-980-5700
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI75212355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty