| Doctor Name: | CARMEN RAFOSO RIVAS |
| NPI Number: | 1093991291 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., SLP |
| License Number: | SA12969 |
| Business Practice Address: | 275 Fontainebleau Blvd Ste 225-f Miami, FL - 331724591 |
| Business Phone Number: | 7864705453 |
| Business Fax Number: | 7864838466 |
| Mailing Address: | 816 Nw 11th St, Apt:1009 MIAMI |
| State: | FL |
| Postal Code: | 331363105 |
| Phone Number: | 7864705453 |
| Fax Number: | 7864838466 |
| NPI Enumeration Date: | 01/17/2008 |
| NPI Last Update Date: | 05/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA12969 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |