MEDICARE: JOYCE IVERSON 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	7694	TN

General Provider Information

NPI Number	:	1063135465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE IVERSON SLP

Provider Business Mailing Address
First Line	:	5332 AVION PARK DR STE 300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1412
Country	:	US
Telephone Number	:	813-829-0767
Fax Number	:

Provider Business Practice Location Address
First Line	:	5332 AVION PARK DR STE 300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1412
Country	:	US
Telephone Number	:	813-829-0767
Fax Number	:

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

Provider Enumeration Date	:	09/21/2022
Last Update Date	:	08/01/2023

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Directions to “ JOYCE IVERSON SLP” Practice Location

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