MEDICARE: MARCIA KAGAN MA,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	SA5886	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	:	1265582944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA KAGAN MA,CCC-SLP

Provider Business Mailing Address
First Line	:	5598 N OCEAN BLVD
Second Line	:
City	:	OCEAN RIDGE
State	:	FL
Zip	:	33435-7074
Country	:	US
Telephone Number	:	561-926-1236
Fax Number	:	561-734-9311

Provider Business Practice Location Address
First Line	:	5598 N OCEAN BLVD
Second Line	:
City	:	OCEAN RIDGE
State	:	FL
Zip	:	33435-7074
Country	:	US
Telephone Number	:	561-926-1236
Fax Number	:	561-734-9311

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/06/2008

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