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General NPI Number Information
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NPI Number | 1508295155
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Entity Type | Organization
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Legal Business Name | SPEECH INNOVATIONS OF CENTRAL FLORIDA LLC
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 253 PLAZA DR STE C
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City | OVIEDO
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State | FL
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Zip | 32765
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Country | US
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Telephone | 407-694-3603
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Fax | 321-296-7130
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Provider Business Mailing Address
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Address Line | 2080 W EAU GALLIE BLVD STE A
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City | MELBOURNE
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State | FL
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Zip | 32935-3185
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Country | US
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Telephone | 407-694-3603
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Fax | 321-296-7130
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Authorized Official
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Title or Position | OWNER
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Name | JANE KATHERINE AUTENRIETH
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Credential | MA, CCC-SLP
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Telephone | 407-694-3603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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