MEDICARE: MICHELLE RETSKY

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	SA24626	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA24646	OTHER	FL	SLP LICENSURE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861041527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE RETSKY

Provider Business Mailing Address
First Line	:	9917 SAN SIERRA WAY
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-3556
Country	:	US
Telephone Number	:	813-653-1149
Fax Number	:

Provider Business Practice Location Address
First Line	:	9917 SAN SIERRA WAY
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-3556
Country	:	US
Telephone Number	:	813-653-1149
Fax Number	:

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

Provider Enumeration Date	:	09/05/2019
Last Update Date	:	06/01/2026

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Directions to “ MICHELLE RETSKY ” Practice Location

Language	Start Address	Practice Location

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