=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386966786
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY ATKINS M.S., CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2010
-----------------------------------------------------
Last Update Date | 07/20/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 CARILLON PKWY
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33716-1115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-571-1210
-----------------------------------------------------
Fax | 727-573-1958
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 CARILLON PKWY
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33716-1115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-571-1210
-----------------------------------------------------
Fax | 727-573-1958
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SA 10843
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------