1326316696 NPI number — SPEECH CONNECTION LLC

Table of content: (NPI 1326316696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326316696 NPI number — SPEECH CONNECTION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPEECH CONNECTION LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LLC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326316696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16697 SHELL BAY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAND O LAKES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34638-5749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-631-2466
Provider Business Mailing Address Fax Number:
813-345-2896

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16697 SHELL BAY DR BAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAND O LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34638-5749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-631-2466
Provider Business Practice Location Address Fax Number:
813-345-2896
Provider Enumeration Date:
12/01/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PORRECA
Authorized Official First Name:
TINA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/MANAGER
Authorized Official Telephone Number:
727-631-2466

Provider Taxonomy Codes

  • Taxonomy code: 222Q00000X , with the licence number:  SA8085 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 224Z00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225200000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2355S0801X , with the licence number: SA8085 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: SA8085 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 252Y00000X , with the licence number: SA8085 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009661900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 013550300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010868800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".