Healthcare Provider Details

I. General information

NPI: 1508837808
Provider Name (Legal Business Name): JOAN D COMRIE SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 KOGER BLVD N STE 213
ST PETERSBURG FL
33702-2466
US

IV. Provider business mailing address

137 1ST ST W
TIERRA VERDE FL
33715-1702
US

V. Phone/Fax

Practice location:
  • Phone: 727-217-5023
  • Fax: 727-279-4977
Mailing address:
  • Phone: 727-317-7655
  • Fax: 727-279-4977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA14043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: