1780022160 NPI number — MRS. ESTHER M MIRANDA BENDEZU MS; CCC-SLP; TSSLD

Table of content: MRS. ESTHER M MIRANDA BENDEZU MS; CCC-SLP; TSSLD (NPI 1780022160)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780022160 NPI number — MRS. ESTHER M MIRANDA BENDEZU MS; CCC-SLP; TSSLD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIRANDA BENDEZU
Provider First Name:
ESTHER
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS; CCC-SLP; TSSLD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780022160
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2309 WHISPERING MAPLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32837-6706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-343-0133
Provider Business Mailing Address Fax Number:
914-455-0158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2309 WHISPERING MAPLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32837-6706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-343-0133
Provider Business Practice Location Address Fax Number:
914-455-0158
Provider Enumeration Date:
06/07/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  021488 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03652357 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110841000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".