MEDICARE: MARINA J SCHUTTE MA, 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	SA9302	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA 9302	OTHER	FL	DOH LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184867293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA J SCHUTTE MA, CCC-SLP

Provider Business Mailing Address
First Line	:	509 DELMONICO ST NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-3104
Country	:	US
Telephone Number	:	321-961-4957
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 DELMONICO ST NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-3104
Country	:	US
Telephone Number	:	321-961-4957
Fax Number	:

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

Provider Enumeration Date	:	04/20/2009
Last Update Date	:	07/18/2014

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Directions to “ MARINA J SCHUTTE MA, CCC-SLP” Practice Location

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