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General NPI Number Information
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NPI Number | 1730737834
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Entity Type | Organization
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Legal Business Name | MANDARIN READING CLINIC
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Dates
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Enumeration Date | 09/01/2019
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Last Update Date | 09/01/2019
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 913
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5217
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Country | US
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Telephone | 904-485-0590
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Fax |
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Provider Business Mailing Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 913
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5217
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Country | US
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Telephone | 904-485-0590
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Fax |
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MARCY RUDOWITZ
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Credential |
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Telephone | 904-485-0590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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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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