MEDICARE: CORNERSTONE COMMUNICATION 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	SA 10919	FL

General Provider Information

NPI Number	:	1457619801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE COMMUNICATION INC.

Provider Business Mailing Address
First Line	:	PO BOX 5215
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32783-5215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4035 WINTER TER
Second Line	:
City	:	TITUSVILLE
State	:	FL
Zip	:	32780-6000
Country	:	US
Telephone Number	:	321-289-2640
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KERA O'BRIEN
Credential	:
Telephone Number	:	321-289-2640

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	04/23/2012

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Directions to “CORNERSTONE COMMUNICATION INC. ” Practice Location

Language	Start Address	Practice Location

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