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General NPI Number Information
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NPI Number | 1679260517
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Entity Type | Organization
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Legal Business Name | SUCCESS SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 2640 CYPRESS RIDGE BLVD STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6318
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Country | US
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Telephone | 877-823-4283
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 SW 75TH ST STE B
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City | GAINESVILLE
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State | FL
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Zip | 32607-3425
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN DENNIS ADELINIS
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Credential |
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Telephone | 352-332-8588
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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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