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General NPI Number Information
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NPI Number | 1831088806
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Entity Type | Organization
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Legal Business Name | PRIMECARE SPEECH SERVICES LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 220 SE 2ND ST APT 1218
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-4183
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Country | US
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Telephone | 954-789-1694
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Fax |
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Provider Business Mailing Address
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Address Line | 220 SE 2ND ST APT 1218
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-4183
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Country | US
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Telephone | 954-789-1694
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLGIST
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Name | GINA MENDELLA
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Credential | MS., CCC-SLP
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Telephone | 954-789-1694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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