MEDICARE: CLAIRE ELENA BYRNE

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	SA13924	FL
2	235Z00000X	Speech-Language Pathologist	2202007208	VA
3	235Z00000X	Speech-Language Pathologist	110865	TX

General Provider Information

NPI Number	:	1417385824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE ELENA BYRNE

Provider Business Mailing Address
First Line	:	1762 SEA LARK LN
Second Line	:
City	:	NAVARRE
State	:	FL
Zip	:	32566-7406
Country	:	US
Telephone Number	:	850-204-8030
Fax Number	:	850-204-8031

Provider Business Practice Location Address
First Line	:	1762 SEA LARK LN
Second Line	:
City	:	NAVARRE
State	:	FL
Zip	:	32566-7406
Country	:	US
Telephone Number	:	850-204-8030
Fax Number	:	850-204-8031

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

Provider Enumeration Date	:	10/22/2013
Last Update Date	:	11/29/2016

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Directions to “ CLAIRE ELENA BYRNE ” Practice Location

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