Healthcare Provider Details

I. General information

NPI: 1396456075
Provider Name (Legal Business Name): MRS K SPEECH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 09/02/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 GIRON CIR
KISSIMMEE FL
34758-2057
US

IV. Provider business mailing address

7268 CANALI WAY
WINTER GARDEN FL
34787-0118
US

V. Phone/Fax

Practice location:
  • Phone: 407-463-1099
  • Fax:
Mailing address:
  • Phone: 407-463-1099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code224ZF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapy Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. KATHERINE PAREDES
Title or Position: SLP-OWNER
Credential: CCC-SLP. MS
Phone: 407-463-1099