| Doctor Name: | MRS. JACKQUELINE BLEZIO |
| NPI Number: | 1588799589 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., C.C.C. |
| License Number: | SA7994 |
| Business Practice Address: | 20700 W Dixie Hwy Aventura, FL - 331801146 |
| Business Phone Number: | 3059335887 |
| Business Fax Number: | |
| Mailing Address: | 11428 Sw 74th St, MIAMI |
| State: | FL |
| Postal Code: | 331732683 |
| Phone Number: | 3056303795 |
| Fax Number: | |
| NPI Enumeration Date: | 02/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA7994 |
| 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 |