MEDICARE: MS. SHARON CASTRILLON GENUARDI MS, 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	SA1467	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA1467	OTHER	FL	LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326284019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON CASTRILLON GENUARDI MS, CCC-SLP

Provider Business Mailing Address
First Line	:	613 N EXCELDA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1623
Country	:	US
Telephone Number	:	813-875-2984
Fax Number	:

Provider Business Practice Location Address
First Line	:	613 N EXCELDA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1623
Country	:	US
Telephone Number	:	813-875-2984
Fax Number	:

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

Provider Enumeration Date	:	12/30/2008
Last Update Date	:	12/30/2008

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