MEDICARE: CALLIE ANN GRIFFIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	222Q00000X	Developmental Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1659963288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALLIE ANN GRIFFIN

Provider Business Mailing Address
First Line	:	12220 TOWNE LAKE DR STE 1
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8021
Country	:	US
Telephone Number	:	239-433-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	8961 DANIELS CENTER DR STE 401
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-0314
Country	:	US
Telephone Number	:	239-433-6700
Fax Number	:

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

Provider Enumeration Date	:	02/04/2021
Last Update Date	:	03/09/2026

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Directions to “ CALLIE ANN GRIFFIN ” Practice Location

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