MEDICARE: STEPHANIE ROSE CUMMINGS M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	235Z00000X	Speech-Language Pathologist	SZ7002	FL
3	235Z00000X	Speech-Language Pathologist	SA 14209	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003176181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ROSE CUMMINGS M.S.

Provider Business Mailing Address
First Line	:	729 SE 13TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-6004
Country	:	US
Telephone Number	:	631-835-3439
Fax Number	:

Provider Business Practice Location Address
First Line	:	729 SE 13TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-6004
Country	:	US
Telephone Number	:	631-835-3439
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2012
Last Update Date	:	07/21/2016

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Directions to “ STEPHANIE ROSE CUMMINGS M.S.” Practice Location

Language	Start Address	Practice Location

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