Healthcare Provider Details

I. General information

NPI: 1497097117
Provider Name (Legal Business Name): MRS. EMILY ANN MARATTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14428 TURNING LEAF DRIVE
ORLANDO FL
32828
US

IV. Provider business mailing address

3728 CRESWICK CIR
ORLANDO FL
32829-7394
US

V. Phone/Fax

Practice location:
  • Phone: 321-961-3489
  • Fax:
Mailing address:
  • Phone: 407-440-4985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ12045
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: