Tracy Ender
Individual provider Active NPI Speech-Language Pathologist · Heathrow, FL
NPI 1376707703 · NPPES record last updated Jul 15, 2008
Key facts
- NPI
- 1376707703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 104245 (WA)
- Practice address
- 1485 International Pkwy
#2051
Heathrow, FL 32746-5303 - Phone
- (800) 798-6035
- NPI assigned
- Jul 15, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104245 | WA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Voyage Staffing | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 104245 | WA | Yes |
Addresses
Primary practice location
1485 International Pkwy
#2051
Heathrow, FL 32746-5303
Mailing address
1485 International Pkwy
#2051
Heathrow, FL 32746-5303
Phone (800) 798-6035
Other providers in Heathrow, FL
- Colleen Donnelly
- Darrin Patrick Downing
- Latanya Earnest
- Sarah Eiseman
- John Ender
- Fly Wheel Center FL LLC
- Justin Fojo
- Stacey Fournier
- Ashley Galvin
- Kaisen Garcia
All providers in Heathrow, FL · Speech-Language Pathologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.