MEDICARE: BROWARD SPEECH AND LANGUAGE

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	SA11314	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	:	1255867818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWARD SPEECH AND LANGUAGE

Provider Business Mailing Address
First Line	:	2212 NE 17TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-2602
Country	:	US
Telephone Number	:	908-692-1687
Fax Number	:

Provider Business Practice Location Address
First Line	:	2212 NE 17TH CT
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-2602
Country	:	US
Telephone Number	:	908-692-1687
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	MICHELE LEE SCHULTE
Credential	:	MA, CCC-SLP
Telephone Number	:	908-692-1687

Provider Enumeration Date	:	05/02/2017
Last Update Date	:	05/02/2017

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Directions to “BROWARD SPEECH AND LANGUAGE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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