MEDICARE: MELITZA PIZARRO 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	SA14309	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y911W	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255006318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELITZA PIZARRO M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 917770
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-0001
Country	:	US
Telephone Number	:	813-821-8038
Fax Number	:	813-974-0483

Provider Business Practice Location Address
First Line	:	4202 E FOWLER AVE STOP PCD1017
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33620-4342
Country	:	US
Telephone Number	:	813-821-8038
Fax Number	:	813-974-0483

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

Provider Enumeration Date	:	08/11/2021
Last Update Date	:	12/03/2024

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Directions to “ MELITZA PIZARRO M.S. CCC-SLP” Practice Location

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