=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972643120
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANA CRISTINA ZIEGLER CCC - SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2007
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1871 CORAL CIR
-----------------------------------------------------
City | NORTH FORT MYERS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33903-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-478-7676
-----------------------------------------------------
Fax | 239-995-2924
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1871 CORAL CIR
-----------------------------------------------------
City | NORTH FORT MYERS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33903-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-478-7676
-----------------------------------------------------
Fax | 239-995-2924
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SA6119
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------