MEDICARE: COMMUNICATION AVENUE CATALYSTS LLC

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

General Provider Information

NPI Number	:	1144954066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNICATION AVENUE CATALYSTS LLC

Provider Business Mailing Address
First Line	:	1431 SIMPSON RD # 56
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-4604
Country	:	US
Telephone Number	:	863-602-6209
Fax Number	:

Provider Business Practice Location Address
First Line	:	7004 TAVISTOCK LAKES BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7731
Country	:	US
Telephone Number	:	863-602-6209
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MS. PRASHANTHI PENDEM
Credential	:	M.S. CCC-SLP
Telephone Number	:	863-602-6209

Provider Enumeration Date	:	07/15/2022
Last Update Date	:	12/06/2023

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Directions to “COMMUNICATION AVENUE CATALYSTS LLC ” Practice Location

Language	Start Address	Practice Location

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