Provider Demographics
NPI:1851188064
Name:IRIZARRY, DAIJA LEANNE (CF-SLP)
Entity type:Individual
Prefix:
First Name:DAIJA
Middle Name:LEANNE
Last Name:IRIZARRY
Suffix:
Gender:
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 TEALWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-9336
Mailing Address - Country:US
Mailing Address - Phone:352-277-7186
Mailing Address - Fax:
Practice Address - Street 1:437 W ARDICE AVE
Practice Address - Street 2:SUITE 481
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726
Practice Address - Country:US
Practice Address - Phone:352-747-4147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12565235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist