Healthcare Provider Details

I. General information

NPI: 1497225130
Provider Name (Legal Business Name): DAVID GREGORIO MA, CF-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1858 N ALAFAYA TRL STE 207
ORLANDO FL
32826-4754
US

IV. Provider business mailing address

911 N ORANGE AVE APT 405
ORLANDO FL
32801-1070
US

V. Phone/Fax

Practice location:
  • Phone: 407-900-5313
  • Fax: 888-972-5443
Mailing address:
  • Phone: 727-282-2764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ8654
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: