Provider Demographics
NPI:1316657406
Name:ANDUJAR, NAYDA LIZZETE (SLP)
Entity type:Individual
Prefix:
First Name:NAYDA
Middle Name:LIZZETE
Last Name:ANDUJAR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14153 SW 163RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2055
Mailing Address - Country:US
Mailing Address - Phone:305-281-1130
Mailing Address - Fax:
Practice Address - Street 1:14153 SW 163RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2055
Practice Address - Country:US
Practice Address - Phone:305-281-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2759235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist