=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407095656
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABC THERAPIES OF FLORIDA, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2009
-----------------------------------------------------
Last Update Date | 02/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 890 NORTHERN WAY SUITE E
-----------------------------------------------------
City | WINTER SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32708-3880
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-340-2718
-----------------------------------------------------
Fax | 321-206-4627
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 195428
-----------------------------------------------------
City | WINTER SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32719-5428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-340-2718
-----------------------------------------------------
Fax | 321-206-4627
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | MRS. CHERYL ELIZABETH TOWNSEND
-----------------------------------------------------
Credential | M.A. CCC-SLP
-----------------------------------------------------
Telephone | 407-340-2718
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SA7884
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------