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General NPI Number Information
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NPI Number | 1831988310
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Entity Type | Organization
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Legal Business Name | SEASIDE SPEECH SERVICES
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 4007 MILANO RD
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City | PANAMA CITY
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State | FL
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Zip | 32405-3208
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Country | US
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Telephone | 352-572-4768
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Fax |
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Provider Business Mailing Address
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Address Line | 4007 MILANO RD
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City | PANAMA CITY
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State | FL
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Zip | 32405-3208
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Country | US
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Telephone | 352-572-4767
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTY TABOR ALVARADO
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Credential | MA CCC-SLP
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Telephone | 352-574-4768
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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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