Provider Demographics
NPI:1396049656
Name:PAREDES VERA, LILA GISELLE
Entity type:Individual
Prefix:
First Name:LILA
Middle Name:GISELLE
Last Name:PAREDES VERA
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 1:1723 SW 2ND AVE APT 1202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2164
Mailing Address - Country:US
Mailing Address - Phone:917-622-5417
Mailing Address - Fax:305-397-1181
Practice Address - Street 1:1723 SW 2ND AVE APT 1202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129
Practice Address - Country:US
Practice Address - Phone:917-622-5417
Practice Address - Fax:305-397-1181
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019232235Z00000X
FL12058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist