MEDICARE: MRS. JANICE MARIE DIMONDA 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
1	235Z00000X	Speech-Language Pathologist	0111261	NY
2	235Z00000X	Speech-Language Pathologist	SA16220	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801040498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANICE MARIE DIMONDA CCC-SLP

Provider Business Mailing Address
First Line	:	5407 FIRETHORN PT
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-9512
Country	:	US
Telephone Number	:	315-408-3421
Fax Number	:

Provider Business Practice Location Address
First Line	:	5327 COMMERCIAL WAY UNIT A102
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-1499
Country	:	US
Telephone Number	:	727-314-5326
Fax Number	:

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

Provider Enumeration Date	:	11/09/2008
Last Update Date	:	10/25/2021

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Directions to “ MRS. JANICE MARIE DIMONDA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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