MEDICARE: MS. JESSELL POSADA M.S., 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	SA 8904	FL

General Provider Information

NPI Number	:	1215097431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSELL POSADA M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	3040 NE 16TH AVE
Second Line	:	SUITE 205 A
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-5207
Country	:	US
Telephone Number	:	954-816-4227
Fax Number	:

Provider Business Practice Location Address
First Line	:	3040 NE 16TH AVE
Second Line	:	SUITE 205 A
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-5207
Country	:	US
Telephone Number	:	954-816-4227
Fax Number	:

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/09/2007

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Directions to “ MS. JESSELL POSADA M.S., CCC-SLP” Practice Location

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