MEDICARE: GABRIELLA LALAMA

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	2355S0801X	Speech-Language Assistant	SI7288	FL

General Provider Information

NPI Number	:	1962239038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLA LALAMA

Provider Business Mailing Address
First Line	:	2874 RESERVE VIEW BLVD APT 204
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-5232
Country	:	US
Telephone Number	:	201-446-0780
Fax Number	:

Provider Business Practice Location Address
First Line	:	2874 RESERVE VIEW BLVD APT 204
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-5232
Country	:	US
Telephone Number	:	201-446-0780
Fax Number	:

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

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	09/13/2024

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Directions to “ GABRIELLA LALAMA ” Practice Location

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