MEDICARE: ANGELE D. JABRE 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
1	235Z00000X	Speech-Language Pathologist	4774	MA
2	235Z00000X	Speech-Language Pathologist	SP.10785	OH
3	235Z00000X	Speech-Language Pathologist	SA12775	FL
4	235Z00000X	Speech-Language Pathologist	22004444A	IN

General Provider Information

NPI Number	:	1699132118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELE D. JABRE M.A, CCC-SLP

Provider Business Mailing Address
First Line	:	5174 COTE DU RHONE WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-4470
Country	:	US
Telephone Number	:	317-607-2135
Fax Number	:

Provider Business Practice Location Address
First Line	:	5174 COTE DU RHONE WAY
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-4470
Country	:	US
Telephone Number	:	317-607-2135
Fax Number	:

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

Provider Enumeration Date	:	01/28/2016
Last Update Date	:	01/28/2016

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Directions to “ ANGELE D. JABRE M.A, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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