Healthcare Provider Details

I. General information

NPI: 1104731793
Provider Name (Legal Business Name): SPEECH THERAPY OF TAMPA BAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28826 MIDNIGHT STAR LOOP
WESLEY CHAPEL FL
33543-6413
US

IV. Provider business mailing address

28826 MIDNIGHT STAR LOOP
WESLEY CHAPEL FL
33543-6413
US

V. Phone/Fax

Practice location:
  • Phone: 727-207-2956
  • Fax:
Mailing address:
  • Phone: 727-207-2956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JULIE KRAL
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: MS, CCC-SLP
Phone: 727-207-2956