MEDICARE: MRS. KRIS-ANN SIMONE CHIN-AMBROSE 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
1	235Z00000X	Speech-Language Pathologist	SA5899	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	SA5899	OTHER	FL	PROFESSIONAL LICENSE
3	12031814	OTHER		ASHA CERTIFICATION

General Provider Information

NPI Number	:	1891749453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRIS-ANN SIMONE CHIN-AMBROSE MS, CCC-SLP

Provider Business Mailing Address
First Line	:	8830 S LAKE DASHA DR
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3011
Country	:	US
Telephone Number	:	305-283-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	8830 S LAKE DASHA DR
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3011
Country	:	US
Telephone Number	:	305-283-4800
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	01/21/2022

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Directions to “ MRS. KRIS-ANN SIMONE CHIN-AMBROSE MS, CCC-SLP” Practice Location

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