1356578322 NPI number — MRS. ANDREA NICOLE MCNAMARA CF-SLP, M.S.

Table of content: MRS. ANDREA NICOLE MCNAMARA CF-SLP, M.S. (NPI 1356578322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356578322 NPI number — MRS. ANDREA NICOLE MCNAMARA CF-SLP, M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNAMARA
Provider First Name:
ANDREA
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CF-SLP, M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ST. MARIE
Provider Other First Name:
ANDREA
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356578322
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2701 N ROCKY POINT DR
Provider Second Line Business Mailing Address:
SUITE 650
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33607-5917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-892-0640
Provider Business Mailing Address Fax Number:
800-892-0648

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2701 N ROCKY POINT DR
Provider Second Line Business Practice Location Address:
SUITE 650
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33607-5917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-892-0640
Provider Business Practice Location Address Fax Number:
800-892-0648
Provider Enumeration Date:
06/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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