MEDICARE: KRISTIN J PAULSON M.S. CCC-SLP

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	SA7136	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	:	1437293610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN J PAULSON M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	50 SW 10TH ST APT 504
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-4129
Country	:	US
Telephone Number	:	786-457-6074
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 SW 10TH ST APT 504
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-4129
Country	:	US
Telephone Number	:	786-457-6074
Fax Number	:

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/09/2007

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