MEDICARE: S.P.O.T. THERAPY CENTER

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	SA6119	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	:	1407177033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S.P.O.T. THERAPY CENTER

Provider Business Mailing Address
First Line	:	2328 HANCOCK BRIDGE PKWY
Second Line	:	SUITE 106
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-1459
Country	:	US
Telephone Number	:	239-573-2368
Fax Number	:	239-573-2302

Provider Business Practice Location Address
First Line	:	2328 HANCOCK BRIDGE PKWY
Second Line	:	SUITE 106
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-1459
Country	:	US
Telephone Number	:	239-573-2368
Fax Number	:	239-573-2302

Authorized Official
Title or Position	:	SPEECH AND LANGUAGE PATHOLOGIST
Name	:	MRS. ANA CRISTINA ZIEGLER
Credential	:	MS-CCC-SLP
Telephone Number	:	239-478-7676

Provider Enumeration Date	:	06/17/2010
Last Update Date	:	10/20/2010

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Directions to “S.P.O.T. THERAPY CENTER ” Practice Location

Language	Start Address	Practice Location

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