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NPI Code Detail

MEDICARE: MS. MARY DORSEY SEKERES MA CCC-SLP

MEDICARE:  MS. MARY DORSEY SEKERES  MA 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 PathologistSA9150FL

Other Identifiers

General Provider Information

NPI Number : 1851432082
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY DORSEY SEKERES MA CCC-SLP
Provider Business Mailing Address
First Line : 213 CHARLEMAGNE CIR
Second Line :
City : PONTE VEDRA BEACH
State : FL
Zip : 32082-2906
Country : US
Telephone Number : 321-438-7151
Fax Number :
Provider Business Practice Location Address
First Line : 2730 ISABELLA BLVD STE 10
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-8002
Country : US
Telephone Number : 904-853-6830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 04/04/2017

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Directions to “ MS. MARY DORSEY SEKERES MA CCC-SLP” Practice Location

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