| Slp360, Inc. | |
|
2814 Lincoln St Hollywood FL 33020-3834 | |
| (786) 439-5550 | |
| (888) 335-8617 |
| Full Name | Slp360, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 2814 Lincoln St, Hollywood, Florida |
| Authorized Official Name and Position | Tiara L Cottle (PRESIDENT) |
| Authorized Official Contact | 7864395550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Slp360, Inc. 2814 Lincoln St Hollywood FL 33020 Ph: (786) 439-5550 | Slp360, Inc. 2814 Lincoln St Hollywood FL 33020-3834 Ph: (786) 439-5550 |
| NPI Number | 1609100486 |
|---|---|
| Provider Enumeration Date | 09/25/2009 |
| Last Update Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609100486 | NPI | - | NPPES |
| 11982414 | Other | FL | CAQH |
| 891202501 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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