MEDICARE: JENNIFER LYNN RAZOOK MS, 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	SA8165	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

General Provider Information

NPI Number	:	1629198411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN RAZOOK MS, CCC-SLP

Provider Business Mailing Address
First Line	:	11003 MYRTLE OAK CT
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3288
Country	:	US
Telephone Number	:	561-707-1058
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 S CONGRESS AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3823
Country	:	US
Telephone Number	:	561-707-1058
Fax Number	:

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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