Healthcare Provider Details
I. General information
NPI: 1821340084
Provider Name (Legal Business Name): JULIE A PERKOWSKI SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/11/2012
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1525 S ALAFAYA TRL SUITE 101
ORLANDO FL
32828-8926
US
IV. Provider business mailing address
14623 SWEET ACACIA DR
ORLANDO FL
32828-7337
US
V. Phone/Fax
- Phone: 407-384-2767
- Fax: 321-281-4942
- Phone: 727-698-9786
- Fax: 321-281-4942
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SZ6051 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: