Provider Demographics
NPI: | 1447265822 |
---|---|
Name: | BI-COUNTY SPEECH LANGUAGE PATHOLOGY, INC. |
Entity type: | Organization |
Organization Name: | BI-COUNTY SPEECH LANGUAGE PATHOLOGY, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | STEPHANIE |
Authorized Official - Middle Name: | EISEN |
Authorized Official - Last Name: | GILFARB |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS CCC-SLP |
Authorized Official - Phone: | 954-312-3449 |
Mailing Address - Street 1: | 4301 S FLAMINGO RD |
Mailing Address - Street 2: | #101 |
Mailing Address - City: | DAVIE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33330-1902 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 954-312-3449 |
Mailing Address - Fax: | 954-251-2752 |
Practice Address - Street 1: | 4301 S FLAMINGO RD |
Practice Address - Street 2: | 101 |
Practice Address - City: | DAVIE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33330-1902 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-312-3449 |
Practice Address - Fax: | 954-251-2752 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-31 |
Last Update Date: | 2022-10-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 888175800 | Medicaid |