MEDICARE: WORDS OF WONDER SPEECH-LANGUAGE PATHOLOGY SERVCES, 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	SA8897	FL
2	235Z00000X	Speech-Language Pathologist	SA9030	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	:	1225440340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORDS OF WONDER SPEECH-LANGUAGE PATHOLOGY SERVCES, LLC.

Provider Business Mailing Address
First Line	:	2042 MICHAEL TIAGO CIR
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-8669
Country	:	US
Telephone Number	:	352-817-4765
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 LAKE BALDWIN LN
Second Line	:	APT. 203
City	:	ORLANDO
State	:	FL
Zip	:	32814-6751
Country	:	US
Telephone Number	:	407-443-1962
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. MELISSA M QADRI
Credential	:	M.A., CCC-SLP
Telephone Number	:	352-817-4765

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	08/05/2014

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Directions to “WORDS OF WONDER SPEECH-LANGUAGE PATHOLOGY SERVCES, LLC. ” Practice Location

Language	Start Address	Practice Location

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