1801025101 NPI number — CARLOTTA MICKEL LOWENSTEIN MA, SLP

Table of content: CARLOTTA MICKEL LOWENSTEIN MA, SLP (NPI 1801025101)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801025101 NPI number — CARLOTTA MICKEL LOWENSTEIN MA, SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MICKEL LOWENSTEIN
Provider First Name:
CARLOTTA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LOWENSTEIN
Provider Other First Name:
CARLOTTA
Provider Other Middle Name:
MICKEL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, SLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1801025101
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2641 LITTLE BEND PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRITT ISLAND
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32952-4161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7201 GREENBORO DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MELBOURNE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32904-1698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-727-0990
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2009

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 , with the licence number:  SZ4794 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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