Provider Demographics
NPI:1962172775
Name:SARDUY, GUIBY (SLP)
Entity type:Individual
Prefix:
First Name:GUIBY
Middle Name:
Last Name:SARDUY
Suffix:
Gender:
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12217 SW 24TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7308
Mailing Address - Country:US
Mailing Address - Phone:786-612-7585
Mailing Address - Fax:
Practice Address - Street 1:5901 NW 151ST ST STE 124
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2454
Practice Address - Country:US
Practice Address - Phone:786-432-5099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty