Jeffry Antonio Barquero Salazar

Individual provider Active NPI Speech-Language Pathologist · Fern Park, FL

NPI 1508220484 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1508220484
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SI2776 (FL)
Practice address
107 Eastwind LN
Fern Park, FL 32730-2911
Phone
(407) 233-7361
NPI assigned
Apr 7, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SI2776FLMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Speech-Language Pathologist 235Z00000X SI2776 FL Yes

Addresses

Primary practice location

107 Eastwind LN
Fern Park, FL 32730-2911

Mailing address

107 Eastwind LN
Fern Park, FL 32730-2911
Phone (407) 233-7361

Other practice location 1

631 E Oak Ridge Rd
Orlando, FL 32809-4266
Phone (407) 233-7361

Other providers in Fern Park, FL

All providers in Fern Park, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.