MEDICARE: SHARI RESNICK

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	SA2065	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	:	1306204292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI RESNICK

Provider Business Mailing Address
First Line	:	4462 WINDERWOOD CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-2636
Country	:	US
Telephone Number	:	407-296-9999
Fax Number	:	307-852-3301

Provider Business Practice Location Address
First Line	:	4462 WINDERWOOD CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-2636
Country	:	US
Telephone Number	:	407-296-9999
Fax Number	:	307-852-3301

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

Provider Enumeration Date	:	02/05/2016
Last Update Date	:	02/05/2016

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Directions to “ SHARI RESNICK ” Practice Location

Language	Start Address	Practice Location

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