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General NPI Number Information
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NPI Number | 1710336755
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Entity Type | Individual
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Provider Name | TINA DELLA PENNA
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Gender | Female
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 4443 ROWAN RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653
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Country | US
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Telephone | 813-363-8568
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Fax |
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Provider Business Mailing Address
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Address Line | 16834 STANZA CT
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City | TAMPA
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State | FL
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Zip | 33624-1095
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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 |
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Name |
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Credential |
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Telephone |
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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 | SA13199
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License Number State | FL
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