=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063013233
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SERTOMA SPEECH & HEARING FOUNDATION OF FLORIDA INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2020
-----------------------------------------------------
Last Update Date | 10/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5211 US HIGHWAY 19 STE 200
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34652-3914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-312-3881
-----------------------------------------------------
Fax | 727-807-6172
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5211 US HIGHWAY 19 STE 200
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34652-3914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-312-3881
-----------------------------------------------------
Fax | 727-807-6172
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DEBRA GOLINSKI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 727-312-3881
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------