West Orange Speech Pathologist, Inc.
Speech-Language Pathologist in Orlando, FL(View on Map)
Legal Business Name
West Orange Speech Pathologist, Inc.
NPI Number
1073788691
NPI Type
Organization
Enumeration Date
04/24/2008
Specialties
(Taxonomies)Licenses
State
Florida
License Number
SA1245
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 555907
6388 SILVER STAR RD STE 2E
City
Orlando
Orlando
State
FL
FL
Postal Code
32855-5907
32818-3235
Country
US
US
Telephone Number
(407) 298-5300
(407) 298-5300
Authorized Official
Name
Mrs. Linda Tatum-riley
Title or Position
CEO/SLP
Telephone Number
(407) 298-5300
Identifiers
Identifier
202579
882834200
18348
880650196
Identifier State
FL
FL
FL
FL
Identifier Issuer
AMERIGROUP
Unknown
STAYWELL / WELLCARE
MEDWAIVER
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 04/24/2008
Provider Address
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