Healthcare Provider Details

I. General information

NPI: 1942186549
Provider Name (Legal Business Name): TERRYN DYER SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 SAND LAKE RD STE 266
ORLANDO FL
32809-7748
US

IV. Provider business mailing address

730 SAND LAKE RD STE 266
ORLANDO FL
32809-7748
US

V. Phone/Fax

Practice location:
  • Phone: 321-445-1287
  • Fax: 407-386-7448
Mailing address:
  • Phone: 321-445-1287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSI8015
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: