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NPI Code Detail

MEDICARE: MICHELE ANN SACKS M.S. CCC-SLP

MEDICARE: MICHELE ANN SACKS 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
1235Z00000XSpeech-Language PathologistSA3287FL

General Provider Information

NPI Number : 1518004266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE ANN SACKS M.S. CCC-SLP
Provider Business Mailing Address
First Line : 17632 ESPRIT DRIVE
Second Line :
City : TAMPA
State : FL
Zip : 33647
Country : US
Telephone Number : 813-973-8973
Fax Number :
Provider Business Practice Location Address
First Line : 12220 BRUCE B DOWNS BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-9201
Country : US
Telephone Number : 813-631-5048
Fax Number : 813-631-5040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/08/2007

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Directions to “ MICHELE ANN SACKS M.S. CCC-SLP” Practice Location

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