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NPI Code Detail

MEDICARE: MARY E GIANNAMORE M.A. CCC, SLP

MEDICARE: MARY E GIANNAMORE M.A. 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
1235Z00000XSpeech-Language PathologistSA 3140FL

General Provider Information

NPI Number : 1932478021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E GIANNAMORE M.A. CCC, SLP
Provider Business Mailing Address
First Line : 1038 CASTAWAY BLVD
Second Line :
City : VERO BEACH
State : FL
Zip : 32963-2463
Country : US
Telephone Number : 772-563-7242
Fax Number :
Provider Business Practice Location Address
First Line : 1060 6TH AVE
Second Line : SUITES 2 & 3
City : VERO BEACH
State : FL
Zip : 32960-5922
Country : US
Telephone Number : 772-563-7242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2011
Last Update Date : 01/30/2012

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