Healthcare Provider Details

I. General information

NPI: 1417560442
Provider Name (Legal Business Name): MEGAN ANN MUSSO SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 BRUCE B DOWNS BLVD STE 300
WESLEY CHAPEL FL
33544-9215
US

IV. Provider business mailing address

3506 W AZEELE ST APT 140
TAMPA FL
33609-2971
US

V. Phone/Fax

Practice location:
  • Phone: 813-973-1033
  • Fax: 844-495-7168
Mailing address:
  • Phone: 419-677-6194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14500933
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: