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NPI Code Detail

MEDICARE: PALM BEACH SPEECH SERVICES LLC

MEDICARE: PALM BEACH SPEECH SERVICES LLC
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
1208D00000XGeneral Practice Physician
2235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1295493393
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALM BEACH SPEECH SERVICES LLC
Provider Business Mailing Address
First Line : 5956 SANDBIRCH WAY
Second Line :
City : LAKE WORTH
State : FL
Zip : 33463-7228
Country : US
Telephone Number : 561-310-8467
Fax Number :
Provider Business Practice Location Address
First Line : 5956 SANDBIRCH WAY
Second Line :
City : LAKE WORTH
State : FL
Zip : 33463-7228
Country : US
Telephone Number : 561-310-8467
Fax Number :
Authorized Official
Title or Position : SPEECH THERAPIST
Name : JANDY VEGA
Credential : MS CCC-SLP
Telephone Number : 561-310-8467
Provider Enumeration Date : 12/06/2021
Last Update Date : 12/06/2021

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Directions to “PALM BEACH SPEECH SERVICES LLC ” Practice Location

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