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NPI Code Detail

MEDICARE: MRS. BROOKE LEANN ALONSO M.A., CCC-SLP

MEDICARE: MRS. BROOKE LEANN ALONSO M.A., 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 PathologistSA9524FL

General Provider Information

NPI Number : 1558633149
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BROOKE LEANN ALONSO M.A., CCC-SLP
Provider Business Mailing Address
First Line : 6201 OAK SHORE DR
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34771-8686
Country : US
Telephone Number : 321-624-3814
Fax Number :
Provider Business Practice Location Address
First Line : 4641 OLD CANOE CREEK ROAD
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34769-1550
Country : US
Telephone Number : 407-892-7344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2012
Last Update Date : 01/30/2012

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Directions to “ MRS. BROOKE LEANN ALONSO M.A., CCC-SLP” Practice Location

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