Ashley Abraham
Individual provider Active NPI Speech-Language Pathologist · Brandon, FL
NPI 1508312935 · NPPES record last updated Oct 7, 2016
Key facts
- NPI
- 1508312935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SZ7757 (FL)
- Practice address
- 602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900 - Phone
- (813) 653-1149
- Fax
- (813) 654-6644
- NPI assigned
- Aug 26, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SZ7757 | FL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ7757 | FL | Yes |
Addresses
Primary practice location
602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900
Mailing address
602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900
Phone (813) 653-1149
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018873100 | Medicaid | FL |
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- Edward R Abreu
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All providers in Brandon, 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 Oct 7, 2016. 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.