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NPI Code Detail

MEDICARE: SONALI SALIL PATEL MS, CCC-SLP

MEDICARE: SONALI SALIL PATEL 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
1235Z00000XSpeech-Language PathologistSA14120FL

General Provider Information

NPI Number : 1912377565
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONALI SALIL PATEL MS, CCC-SLP
Provider Business Mailing Address
First Line : 11512 LAKE MEAD AVE UNIT 604
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-9686
Country : US
Telephone Number : 904-652-5408
Fax Number :
Provider Business Practice Location Address
First Line : 11512 LAKE MEAD AVE UNIT 604
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-9686
Country : US
Telephone Number : 904-652-5408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2015
Last Update Date : 09/25/2015

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Directions to “ SONALI SALIL PATEL MS, CCC-SLP” Practice Location

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