Healthcare Provider Details

I. General information

NPI: 1467698316
Provider Name (Legal Business Name): LAURIE CAUFIELD SPEECH THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2008
Last Update Date: 12/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5036 SE 110TH ST
BELLEVIEW FL
34420-3116
US

IV. Provider business mailing address

303 SE 17TH ST #309-217
OCALA FL
34471-4421
US

V. Phone/Fax

Practice location:
  • Phone: 352-693-3378
  • Fax: 888-758-9645
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA7949
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: