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General NPI Number Information
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NPI Number | 1003798141
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Entity Type | Individual
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Provider Name | BRAYLEE L SPIDDLE
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Gender | Female
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 17801 HUNTING BOW CIR STE 102
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City | LUTZ
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State | FL
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Zip | 33558-5403
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Country | US
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Telephone | 813-219-0626
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 S WEST SHORE BLVD UNIT 1323
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City | TAMPA
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State | FL
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Zip | 33611-5682
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Country | US
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Telephone | 352-445-3210
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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