=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922903152
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAOLA MARIE CANCEL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/08/2026
-----------------------------------------------------
Last Update Date | 10/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35950 U.S. 19 APT 3211
-----------------------------------------------------
City | PALM HARBOR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-315-3985
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 35950 US HIGHWAY 19 N UNIT 3211
-----------------------------------------------------
City | PALM HARBOR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34684-1575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-315-3985
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2355S0801X
-----------------------------------------------------
Taxonomy Name | Speech-Language Assistant
-----------------------------------------------------
License Number | 005293
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------