MEDICARE: KELLY VARONE MS CF 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

General Provider Information

NPI Number	:	1649734393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY VARONE MS CF SLP

Provider Business Mailing Address
First Line	:	15910 MARSHFIELD DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6924 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-5800
Country	:	US
Telephone Number	:	813-962-6766
Fax Number	:

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

Provider Enumeration Date	:	01/28/2019
Last Update Date	:	01/28/2019

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