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NPI Code Detail

MEDICARE: BRIDGET SCANLAN

MEDICARE:   BRIDGET  SCANLAN
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 PathologistSA 13851FL

General Provider Information

NPI Number : 1528592755
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET SCANLAN
Provider Business Mailing Address
First Line : 7840 BURMA RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6172
Country : US
Telephone Number : 904-693-7523
Fax Number :
Provider Business Practice Location Address
First Line : 7840 BURMA RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6172
Country : US
Telephone Number : 904-693-7523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2017
Last Update Date : 04/14/2017

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Directions to “ BRIDGET SCANLAN ” Practice Location

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