Provider Demographics
NPI:1194293662
Name:VITERI, TERESA MARIA (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIA
Last Name:VITERI
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6635 NERVIA ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3119
Mailing Address - Country:US
Mailing Address - Phone:305-742-9053
Mailing Address - Fax:
Practice Address - Street 1:2103 CORAL WAY STE 720
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-2658
Practice Address - Country:US
Practice Address - Phone:305-443-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty