MEDICARE: DELAINA GAYLE ANDERSON

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		FL

General Provider Information

NPI Number	:	1407713282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELAINA GAYLE ANDERSON

Provider Business Mailing Address
First Line	:	14873 72ND CT N
Second Line	:
City	:	LOXAHATCHEE
State	:	FL
Zip	:	33470-4440
Country	:	US
Telephone Number	:	561-847-0921
Fax Number	:

Provider Business Practice Location Address
First Line	:	2168 S JOG RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33415-6093
Country	:	US
Telephone Number	:	561-641-5757
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “ DELAINA GAYLE ANDERSON ” Practice Location

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