MEDICARE: JAN LEGASPI 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	20251	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	:	1437742111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAN LEGASPI M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	6045 NW WINFIELD DR
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-3738
Country	:	US
Telephone Number	:	818-572-7876
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 S 23RD ST STE 2
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4830
Country	:	US
Telephone Number	:	177-246-4330
Fax Number	:

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

Provider Enumeration Date	:	02/14/2021
Last Update Date	:	12/01/2025

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Directions to “ JAN LEGASPI M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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