Healthcare Provider Details

I. General information

NPI: 1053937482
Provider Name (Legal Business Name): DYSPHAGIA SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5615 RIVA RIDGE DR
WESLEY CHAPEL FL
33544-6511
US

IV. Provider business mailing address

5615 RIVA RIDGE DR
WESLEY CHAPEL FL
33544-6511
US

V. Phone/Fax

Practice location:
  • Phone: 813-294-4388
  • Fax:
Mailing address:
  • Phone: 813-294-4388
  • 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: GERRITA A MORRIS
Title or Position: PRESIDENT/SLP
Credential: M.A., CCC-SLP
Phone: 813-294-4388