Healthcare Provider Details

I. General information

NPI: 1982685426
Provider Name (Legal Business Name): LYNNE C GIULIANO MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 23RD AVE N
ST PETERSBURG FL
33704-3228
US

IV. Provider business mailing address

1068 23RD AVE N
ST PETERSBURG FL
33704-3228
US

V. Phone/Fax

Practice location:
  • Phone: 727-822-6806
  • Fax: 727-825-1750
Mailing address:
  • Phone: 727-822-6806
  • Fax: 727-825-1750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA1009
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: