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NPI Code Detail

MEDICARE: SHANNON MARIE CRESPO SLP

MEDICARE: SHANNON MARIE CRESPO 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 Pathologist6328NC
2235Z00000XSpeech-Language PathologistSA9807FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538224449
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MARIE CRESPO SLP
Provider Business Mailing Address
First Line : 350 BRADEN AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2001
Country : US
Telephone Number : 941-355-7637
Fax Number : 941-355-7637
Provider Business Practice Location Address
First Line : 350 BRADEN AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2001
Country : US
Telephone Number : 941-355-7637
Fax Number : 941-355-7637
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 05/20/2011

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Directions to “ SHANNON MARIE CRESPO SLP” Practice Location

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