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NPI Code Detail

MEDICARE: ANNELISE EVANS CCC SLP

MEDICARE: ANNELISE EVANS 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
1235Z00000XSpeech-Language Pathologist7150TN
2235Z00000XSpeech-Language Pathologist2358NH
3235Z00000XSpeech-Language Pathologist017026PA
4235Z00000XSpeech-Language Pathologist21225FL

General Provider Information

NPI Number : 1447933619
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNELISE EVANS CCC SLP
Provider Business Mailing Address
First Line : 2312 S CAROLINA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-6229
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2312 S CAROLINA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-6229
Country : US
Telephone Number : 850-238-5260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “ ANNELISE EVANS CCC SLP” Practice Location

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