Provider Demographics
NPI:1538915673
Name:CARAZO, JAIDA ALECIA (SLPA)
Entity type:Individual
Prefix:
First Name:JAIDA
Middle Name:ALECIA
Last Name:CARAZO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 S WILLIAMSON BLVD APT 4-111
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-6540
Mailing Address - Country:US
Mailing Address - Phone:912-320-1314
Mailing Address - Fax:
Practice Address - Street 1:808 DUNLAWTON AVE STE 4
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-9284
Practice Address - Country:US
Practice Address - Phone:386-446-9935
Practice Address - Fax:386-446-7777
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI78602355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty