Healthcare Provider Details

I. General information

NPI: 1033396528
Provider Name (Legal Business Name): ABBY L CIOSICI M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2008
Last Update Date: 01/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COBURN RD
SARASOTA FL
34240-8855
US

IV. Provider business mailing address

7017 SCRUB JAY WAY
BRADENTON FL
34203-7188
US

V. Phone/Fax

Practice location:
  • Phone: 941-932-0716
  • Fax: 941-758-2840
Mailing address:
  • Phone: 941-932-0716
  • Fax: 941-758-2840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 8050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: