| Imagine Pediatric Therapy Of Brevard, Llc | |
|
600 N Sonora Cir, Indialantic, FL 32903-3735 | |
| (321) 223-8791 | |
| Not Available |
| Full Name | Imagine Pediatric Therapy Of Brevard, Llc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 600 N Sonora Cir, Indialantic, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942857511 | NPI | - | NPPES |
| 104044500 | Medicaid | FL | |
| 110199500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine Pediatric Therapy Of Brevard, Llc 600 N Sonora Cir, Indialantic, FL 32903-3735 Ph: (321) 223-8791 | Imagine Pediatric Therapy Of Brevard, Llc 600 N Sonora Cir, Indialantic, FL 32903-3735 Ph: (321) 223-8791 |
Michele Krenzer, M.S. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 385 Normandy Dr, Indialantic, FL 32903 Phone: 321-501-2858 | |
Tammy Kaliko Willingham, Inc., MA/SLP/CCC Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 151 Terrace Shores Dr, Indialantic, FL 32903 Phone: 321-984-2789 | |
Page Moorefield Hyler, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 430 Wayne Ave, Indialantic, FL 32903 Phone: 321-609-7292 | |
Mrs. Patricia D Burke, MS/CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 834 Puesta Del Sol Plz, Indialantic, FL 32903 Phone: 321-543-0615 | |
Lisa Farthing, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 412 Rio Villa Blvd, Indialantic, FL 32903 Phone: 321-773-7218 | |
Mrs. Erica Ann Provost, MS, CCC Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 151 Terrace Shores Drive, Indialantic, FL 32903 Phone: 561-801-3264 |