| NPI | 1790548741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LYNN BANUELOS Speech Language Pathologist 727-259-9190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2024-02-02 |