MEDICARE: ULANDA WHITE

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	2355S0801X	Speech-Language Assistant	SI4854	FL

General Provider Information

NPI Number	:	1811688443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ULANDA WHITE

Provider Business Mailing Address
First Line	:	316 WESTHAMPTON DR
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-7878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 WESTHAMPTON DR
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-7878
Country	:	US
Telephone Number	:	646-226-0979
Fax Number	:

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

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	05/18/2023

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Directions to “ ULANDA WHITE ” Practice Location

Language	Start Address	Practice Location

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