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NPI Code Detail

MEDICARE: BROOKE ANDERSON MA CF-SLP

MEDICARE: BROOKE ANDERSON MA CF-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 PathologistSZ6220FL

General Provider Information

NPI Number : 1841637097
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE ANDERSON MA CF-SLP
Provider Business Mailing Address
First Line : 636 N PINE AVE
Second Line :
City : OVIEDO
State : FL
Zip : 32765-8952
Country : US
Telephone Number : 407-968-9600
Fax Number :
Provider Business Practice Location Address
First Line : 1775 HUNTINGTON LN
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-3136
Country : US
Telephone Number : 321-632-7341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2013
Last Update Date : 05/29/2013

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Directions to “ BROOKE ANDERSON MA CF-SLP” Practice Location

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