Healthcare Provider Details

I. General information

NPI: 1346947124
Provider Name (Legal Business Name): JMR SPEECH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6121 AVALON RD
WINTER GARDEN FL
34787-9745
US

IV. Provider business mailing address

6121 AVALON RD
WINTER GARDEN FL
34787
US

V. Phone/Fax

Practice location:
  • Phone: 787-552-6972
  • Fax:
Mailing address:
  • Phone: 787-552-6972
  • 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: MISS JULIANNE M RIVERA
Title or Position: OWNER
Credential: SLP
Phone: 787-552-6972