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General NPI Number Information
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NPI Number | 1477357978
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Entity Type | Organization
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Legal Business Name | KRYSTAL CLEAR SPEECH, LLC
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 150 KASSIK CIR
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City | ORLANDO
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State | FL
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Zip | 32824-5826
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Country | US
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Telephone | 407-502-2441
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Fax | 407-326-3315
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Provider Business Mailing Address
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Address Line | 12397 S ORANGE BLOSSOM TRL STE 21
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City | ORLANDO
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State | FL
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Zip | 32837-6217
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Country | US
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Telephone | 407-502-2441
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Fax | 407-326-3315
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | KRYSTAL GONZALEZ
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Credential | MA, CCC-SLP
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Telephone | 407-502-2441
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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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