MEDICARE: LINDSEY CONSTANTINE M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA11455	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023318797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY CONSTANTINE M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	7512 DR PHILLIPS BLVD
Second Line	:	SUITE 50-703
City	:	ORLANDO
State	:	FL
Zip	:	32819-5131
Country	:	US
Telephone Number	:	407-906-7733
Fax Number	:

Provider Business Practice Location Address
First Line	:	9465 WICKHAM WAY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-5521
Country	:	US
Telephone Number	:	407-906-7733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	12/16/2015

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Directions to “ LINDSEY CONSTANTINE M.A., CCC-SLP” Practice Location

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