Healthcare Provider Details

I. General information

NPI: 1205417227
Provider Name (Legal Business Name): PEYTON BJORKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1342 SE 46TH LN UNIT 1-3
CAPE CORAL FL
33904-8617
US

IV. Provider business mailing address

2201 CANARY ISLAND CV
NAPLES FL
34119-3347
US

V. Phone/Fax

Practice location:
  • Phone: 605-929-6781
  • Fax:
Mailing address:
  • Phone: 605-929-6781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13521
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number41721
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: