MEDICARE: ANNE WOLFE MACNEIL SLP-CCC

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	SA16863	FL
2	235Z00000X	Speech-Language Pathologist	SZ4599	FL
3	235Z00000X	Speech-Language Pathologist	18460	CA

General Provider Information

NPI Number	:	1831329846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE WOLFE MACNEIL SLP-CCC

Provider Business Mailing Address
First Line	:	7412 S FITZGERALD ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33616-2131
Country	:	US
Telephone Number	:	850-221-2010
Fax Number	:

Provider Business Practice Location Address
First Line	:	7412 S FITZGERALD ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33616-2131
Country	:	US
Telephone Number	:	850-221-2010
Fax Number	:

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

Provider Enumeration Date	:	07/24/2009
Last Update Date	:	02/10/2020

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Directions to “ ANNE WOLFE MACNEIL SLP-CCC” Practice Location

Language	Start Address	Practice Location

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