Healthcare Provider Details
I. General information
NPI: 1770307555
Provider Name (Legal Business Name): ZAVISON SPEECH & SWALLOWING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2024
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
575 NIX RD
PENSACOLA FL
32506-8332
US
IV. Provider business mailing address
575 NIX RD
PENSACOLA FL
32506-8332
US
V. Phone/Fax
- Phone: 850-240-2485
- Fax: 850-605-4272
- Phone: 850-240-2485
- Fax: 850-605-4272
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
ZAVISON
Title or Position: PRESIDENT
Credential:
Phone: 866-866-7215