MEDICARE: BILINGUAL SPEECH-LANGUAGE PATHOLOGY, LLC

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	SA10985	FL

General Provider Information

NPI Number	:	1548515703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BILINGUAL SPEECH-LANGUAGE PATHOLOGY, LLC

Provider Business Mailing Address
First Line	:	3632 LAND O LAKES BLVD
Second Line	:	SUITE 104 ROOM 3
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4405
Country	:	US
Telephone Number	:	813-388-3789
Fax Number	:

Provider Business Practice Location Address
First Line	:	3632 LAND O LAKES BLVD
Second Line	:	SUITE 104 ROOM 3
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4405
Country	:	US
Telephone Number	:	813-388-3789
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	DIANA JULBE-DELGADO
Credential	:	M.S.
Telephone Number	:	813-388-3789

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	07/13/2012

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