MEDICARE: THERASPEAK INC.

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	SA9146	FL

General Provider Information

NPI Number	:	1417242363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERASPEAK INC.

Provider Business Mailing Address
First Line	:	17705 NE 9TH PL
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-1114
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17705 NE 9TH PL
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-1114
Country	:	US
Telephone Number	:	718-954-4126
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHANA ROSENBERG
Credential	:
Telephone Number	:	718-954-4126

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	06/17/2011

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Directions to “THERASPEAK INC. ” Practice Location

Language	Start Address	Practice Location

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