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General NPI Number Information
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NPI Number | 1487579249
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Entity Type | Organization
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Legal Business Name | SEASIDE SPEECH AND LANGUAGE THERAPY, PLLC
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 16351 CAPTIVA DR
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City | CAPTIVA
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State | FL
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Zip | 33924
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Country | US
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Telephone | 561-460-6356
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 501
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City | CAPTIVA
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State | FL
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Zip | 33924-0501
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Country | US
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Telephone | 561-460-6356
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PAIGE WINTON
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Credential | M.S., CCC-SLP
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Telephone | 561-460-6356
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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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