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NPI Code Detail

MEDICARE: JADE NEWBERRY SLPA

MEDICARE: JADE NEWBERRY SLPA
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
1235Z00000XSpeech-Language PathologistSZ13272FL

General Provider Information

NPI Number : 1104653583
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE NEWBERRY SLPA
Provider Business Mailing Address
First Line : 3045 N COMMERCE PKWY
Second Line :
City : MIRAMAR
State : FL
Zip : 33025-3927
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5650 S WASHINGTON AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-7312
Country : US
Telephone Number : 386-446-9935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2024
Last Update Date : 05/26/2026

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Directions to “ JADE NEWBERRY SLPA” Practice Location

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