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NPI Code Detail

MEDICARE: MS. EMIE ROSE PENAFIEL

MEDICARE: MS. EMIE ROSE PENAFIEL
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 PathologistSZ4879FL
2235Z00000XSpeech-Language PathologistSA10676FL

Other Identifiers

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

General Provider Information

NPI Number : 1992030282
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EMIE ROSE PENAFIEL
Provider Business Mailing Address
First Line : 4525 BRITTANY HEYWORTH WAY
Second Line : APT. #303
City : LAKELAND
State : FL
Zip : 33813-3177
Country : US
Telephone Number : 614-668-8653
Fax Number :
Provider Business Practice Location Address
First Line : 1215 E ORANGE ST
Second Line :
City : LAKELAND
State : FL
Zip : 33801-5762
Country : US
Telephone Number : 863-802-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2009
Last Update Date : 11/10/2010

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Directions to “ MS. EMIE ROSE PENAFIEL ” Practice Location

Language Start Address Practice Location
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