Healthcare Provider Details

I. General information

NPI: 1629829783
Provider Name (Legal Business Name): MOBILE SWALLOWING DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7726 WINEGARD RD FL 2
ORLANDO FL
32809-7147
US

IV. Provider business mailing address

7726 WINEGARD RD FL 2
ORLANDO FL
32809-7147
US

V. Phone/Fax

Practice location:
  • Phone: 443-848-3577
  • Fax:
Mailing address:
  • Phone: 443-848-3577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JAMES MASON MCELHANEY
Title or Position: SPEECH LANGUAGE PATHOLOGIST / CEO
Credential: CCC-SLP
Phone: 443-848-3577