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General NPI Number Information
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NPI Number | 1518126846
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Entity Type | Organization
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Legal Business Name | LEMON TREE LLC
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 3885 TAMPA RD SUITE A
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City | OLDSMAR
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State | FL
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Zip | 34677-3121
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Country | US
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Telephone | 813-854-3000
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Fax | 813-854-3002
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Provider Business Mailing Address
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Address Line | 3885 TAMPA RD SUITE A
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City | OLDSMAR
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State | FL
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Zip | 34677-3121
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Country | US
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Telephone | 813-854-3000
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Fax | 813-854-3002
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Authorized Official
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Title or Position | SPEECH THERAPIST/DIRECTOR
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Name | MS. MARIA SARAVANOS
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Credential | M.S/CCC-SLP
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Telephone | 813-854-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | SA5567
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License Number State | FL
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