Healthcare Provider Details

I. General information

NPI: 1760821623
Provider Name (Legal Business Name): LYNN MICHELE MONTEIRO CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNN MARTELL

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1858 N ALAFAYA TRL SUITE 207
ORLANDO FL
32826-4728
US

IV. Provider business mailing address

11066 SUSPENSE DR
WINTER GARDEN FL
34787-1752
US

V. Phone/Fax

Practice location:
  • Phone: 407-900-5313
  • Fax:
Mailing address:
  • Phone: 954-648-8431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA13182
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: