Healthcare Provider Details

I. General information

NPI: 1831382381
Provider Name (Legal Business Name): DENISE N SARCO-STIPE MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2007
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16102 N. FLORIDA AVE SUITE 910
LUTZ FL
33549
US

IV. Provider business mailing address

4616 BUCKEYE RD.
TAMPA FL
33624
US

V. Phone/Fax

Practice location:
  • Phone: 813-873-1936
  • Fax: 813-873-8837
Mailing address:
  • Phone: 813-362-1194
  • Fax: 813-362-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA5668
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: