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General NPI Number Information
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NPI Number | 1538345558
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Entity Type | Organization
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Legal Business Name | SUNCOAST PEDIATRIC THERAPY, INC.
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 6100 26TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-4130
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Country | US
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Telephone | 727-215-9917
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Fax | 727-343-0314
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Provider Business Mailing Address
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Address Line | 6100 26TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-4130
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Country | US
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Telephone | 727-215-9917
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Fax | 727-343-0314
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Authorized Official
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Title or Position | PRESIDENT / SLP
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Name | STEPHANIE ANNETTE FRIEDMAN
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Credential | MS, CCC-SLP
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Telephone | 727-215-9917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | SA7160
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License Number State | FL
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