MEDICARE: MRS. CHRISTINE MARIE SHENOI M.S. 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
1	235Z00000X	Speech-Language Pathologist	12104763	FL
2	235Z00000X	Speech-Language Pathologist	SA 8031	FL
3	235Z00000X	Speech-Language Pathologist	146008913	IL
4	235Z00000X	Speech-Language Pathologist	SA15082	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1588713051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE MARIE SHENOI M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	17279 OLD TOBACCO RD
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-4947
Country	:	US
Telephone Number	:	117-274-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	17279 OLD TOBACCO RD
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-4947
Country	:	US
Telephone Number	:	727-422-2438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	06/28/2021

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Directions to “ MRS. CHRISTINE MARIE SHENOI M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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