MEDICARE: SPEECH TIME, INC

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	224Z00000X	Occupational Therapy Assistant
2	2355S0801X	Speech-Language Assistant	SI1035	FL
3	235Z00000X	Speech-Language Pathologist	SA606	FL
4	261QM1300X	Multi-Specialty Clinic/Center

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	:	1194923268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH TIME, INC

Provider Business Mailing Address
First Line	:	1300 CORAL WAY STE 207
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-2934
Country	:	US
Telephone Number	:	305-854-7244
Fax Number	:	786-375-5544

Provider Business Practice Location Address
First Line	:	1450 CORAL WAY
Second Line	:	SUITE 2
City	:	MIAMI
State	:	FL
Zip	:	33145-2856
Country	:	US
Telephone Number	:	305-854-7244
Fax Number	:	305-854-7244

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MRS. MARISA E HECKSTALL
Credential	:
Telephone Number	:	305-854-7244

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	02/21/2020

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Directions to “SPEECH TIME, INC ” Practice Location

Language	Start Address	Practice Location

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