MEDICARE: KASEY LOWER

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	390200000X	Student in an Organized Health Care Education/Training Program
2	235Z00000X	Speech-Language Pathologist	SA19754	FL

General Provider Information

NPI Number	:	1710575527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASEY LOWER

Provider Business Mailing Address
First Line	:	8113 HEAVENS BEND LN
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33565-5807
Country	:	US
Telephone Number	:	813-928-0182
Fax Number	:

Provider Business Practice Location Address
First Line	:	2051 WALDEN WOODS DR
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-3610
Country	:	US
Telephone Number	:	813-695-7418
Fax Number	:

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

Provider Enumeration Date	:	01/07/2021
Last Update Date	:	09/15/2024

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Directions to “ KASEY LOWER ” Practice Location

Language	Start Address	Practice Location

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