=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073616181
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINDA BICKY CASTER, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 925 ARTHUR GODFREY RD #100
-----------------------------------------------------
City | MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33140-3325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-531-0081
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 950 JEFFERSON ST
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33019-1912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-914-6885
-----------------------------------------------------
Fax | 954-920-7898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | MRS. LINDA BICKY CASTER I
-----------------------------------------------------
Credential | M.A.,CCC/SLP
-----------------------------------------------------
Telephone | 954-914-6885
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SA 1653
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------