Healthcare Provider Details

I. General information

NPI: 1477897015
Provider Name (Legal Business Name): ANNA E HURTADO M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2012
Last Update Date: 11/25/2022
Certification Date: 11/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 S DILLARD ST STE 106
WINTER GARDEN FL
34787-3991
US

IV. Provider business mailing address

15037 LAKE BESSIE LOOP
WINTER GARDEN FL
34787-9281
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-0029
  • Fax: 407-358-5207
Mailing address:
  • Phone: 601-606-7059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS3449
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA18456
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: