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NPI Code Detail

MEDICARE: MRS. SUZAN L. LAROCCA MS-SLP/CCC

MEDICARE: MRS. SUZAN L. LAROCCA MS-SLP/CCC
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
1235Z00000XSpeech-Language PathologistSA12777FL
2235Z00000XSpeech-Language Pathologist7357MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112111287OTHERASHA CERTIFICATE OF CLINICAL COMPETENCE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316112519
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUZAN L. LAROCCA MS-SLP/CCC
Provider Business Mailing Address
First Line : 4310 METRO PKWY STE 205
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-9416
Country : US
Telephone Number : 833-362-7935
Fax Number :
Provider Business Practice Location Address
First Line : 4310 METRO PKWY STE 205
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-9416
Country : US
Telephone Number : 833-362-7935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2008
Last Update Date : 10/23/2023

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Directions to “ MRS. SUZAN L. LAROCCA MS-SLP/CCC” Practice Location

Language Start Address Practice Location
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