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NPI Code Detail

MEDICARE: RONESHA ROBERSON MS CCC-SLP

MEDICARE:   RONESHA  ROBERSON  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
1235Z00000XSpeech-Language PathologistSA19274FL

General Provider Information

NPI Number : 1770154460
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONESHA ROBERSON MS CCC-SLP
Provider Business Mailing Address
First Line : 16016 WYNDOVER RD
Second Line :
City : TAMPA
State : FL
Zip : 33647-1046
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 E KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33602-3502
Country : US
Telephone Number : 813-536-7641
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2021
Last Update Date : 07/05/2021

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Directions to “ RONESHA ROBERSON MS CCC-SLP” Practice Location

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