MEDICARE: KAYLEE MERRITT

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	SA17597	FL

General Provider Information

NPI Number	:	1710856810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE MERRITT

Provider Business Mailing Address
First Line	:	3420 MONITOR LN
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1017 STRONG RD
Second Line	:
City	:	QUINCY
State	:	FL
Zip	:	32351-5249
Country	:	US
Telephone Number	:	850-875-3711
Fax Number	:

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

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	11/05/2025

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Directions to “ KAYLEE MERRITT ” Practice Location

Language	Start Address	Practice Location

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