MEDICARE: ADELE KATES M.ED., C.C.C., S.L.P

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	SA236	FL

General Provider Information

NPI Number	:	1790058642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADELE KATES M.ED., C.C.C., S.L.P

Provider Business Mailing Address
First Line	:	1 NE 168TH ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3409
Country	:	US
Telephone Number	:	305-651-6442
Fax Number	:	305-651-5722

Provider Business Practice Location Address
First Line	:	1 NE 168TH ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3409
Country	:	US
Telephone Number	:	305-651-6442
Fax Number	:	305-651-5722

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

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/22/2012

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