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General NPI Number Information
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NPI Number | 1346080777
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Entity Type | Organization
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Legal Business Name | SPEECH WORLD, LLC
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 6614 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32211-8728
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Country | US
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Telephone | 904-685-4267
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Fax | 888-504-5656
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Provider Business Mailing Address
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Address Line | 6614 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32211-8728
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Country | US
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Telephone | 904-685-4267
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Fax | 888-504-5656
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ENAK ALFONSO
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Credential | SLP
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Telephone | 321-507-7965
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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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