Provider Demographics
NPI:1235704560
Name:SPEECH THERAPY CENTER PLLC
Entity type:Organization
Organization Name:SPEECH THERAPY CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLIORADAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-940-3114
Mailing Address - Street 1:5023 FLORA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34690-6616
Mailing Address - Country:US
Mailing Address - Phone:727-940-3114
Mailing Address - Fax:727-940-4107
Practice Address - Street 1:5023 FLORA AVE
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-6616
Practice Address - Country:US
Practice Address - Phone:727-940-3114
Practice Address - Fax:727-940-4107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty