Healthcare Provider Details

I. General information

NPI: 1891118386
Provider Name (Legal Business Name): LOREN CIPION CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 S ALAFAYA TRL STE 310
ORLANDO FL
32828-7977
US

IV. Provider business mailing address

2442 STONE CROSS CIR
ORLANDO FL
32828-7939
US

V. Phone/Fax

Practice location:
  • Phone: 407-294-3344
  • Fax: 407-378-2978
Mailing address:
  • Phone: 718-781-3679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 10822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: