MEDICARE: JESSICA SYDNEY TINTWEISS 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	SA22082	FL

General Provider Information

NPI Number	:	1598516403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SYDNEY TINTWEISS M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	12478 EQUINE LN
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-3508
Country	:	US
Telephone Number	:	631-897-2868
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 PURITAN RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-2903
Country	:	US
Telephone Number	:	631-897-2868
Fax Number	:

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

Provider Enumeration Date	:	03/28/2024
Last Update Date	:	03/28/2024

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