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

LicenseStateTypeSpecialty
SZ7757FLMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
018873100MedicaidFL

Other providers in Brandon, FL

All providers in Brandon, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.