MEDICARE: PATRICIA HERNILDA MCCOWN M.S. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SA16920	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033281738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA HERNILDA MCCOWN M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	833 HARBOR INN DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-5616
Country	:	US
Telephone Number	:	305-989-6911
Fax Number	:

Provider Business Practice Location Address
First Line	:	6862 NW 169TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-4210
Country	:	US
Telephone Number	:	786-615-8426
Fax Number	:	786-801-1724

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	09/23/2022

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Directions to “ PATRICIA HERNILDA MCCOWN M.S. CCC-SLP” Practice Location

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