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NPI Code Detail

MEDICARE: HAYLEI SUMMER RIEDEL

MEDICARE: HAYLEI SUMMER RIEDEL
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
12355S0801XSpeech-Language AssistantSI5760FL

General Provider Information

NPI Number : 1558086520
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYLEI SUMMER RIEDEL
Provider Business Mailing Address
First Line : 1468 NORTHRIDGE DR
Second Line :
City : LONGWOOD
State : FL
Zip : 32750-4548
Country : US
Telephone Number : 407-925-9491
Fax Number :
Provider Business Practice Location Address
First Line : 1061 S SUN DR STE 1089
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-6169
Country : US
Telephone Number : 407-323-6955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2022
Last Update Date : 10/11/2022

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Directions to “ HAYLEI SUMMER RIEDEL ” Practice Location

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