| The Speech Pod | |
|
106 Black Bear Circle, Niceville, FL 32578 | |
| (850) 830-3314 | |
| (850) 904-0355 |
| Full Name | The Speech Pod |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 106 Black Bear Circle, Niceville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366140568 | NPI | - | NPPES |
| 118480700 | Medicaid | FL | |
| SA18378 | Other | FL | DOH |
| 117493600 | Medicaid | FL | |
| 117725200 | Medicaid | FL | |
| 118599100 | Medicaid | FL | |
| 12030298 | Other | MD | ASHA CCC |
| 18378 | Other | FL | FL DOH SLP LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Enri Fort |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497385520 PECOS PAC ID: 3274900782 Enrollment ID: I20221111001354 |
| Mailing Address | Practice Location Address |
|---|---|
| The Speech Pod 106 Black Bear Cir, Niceville, FL 32578-1202 Ph: (850) 830-3314 | The Speech Pod 106 Black Bear Circle, Niceville, FL 32578 Ph: (850) 830-3314 |
Cheryl A Stubbs, CCC SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 410 Olde Post Rd, Niceville, FL 32578 Phone: 850-797-3605 | |
Rachel Parden, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1069 John Sims Pkwy E Ste 4, Niceville, FL 32578 Phone: 850-897-3013 Fax: 850-897-0149 | |
Heather Dew, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1069 John Sims Pkwy E, Suite 4, Niceville, FL 32578 Phone: 850-897-3013 Fax: 850-897-0149 | |
Rebecca Johnson, M.S Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4595 E Highway 20, Niceville, FL 32578 Phone: 850-460-3598 | |
Courtney Wild, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1069 John Sims Pkwy E Ste 4, Niceville, FL 32578 Phone: 850-897-3013 Fax: 850-897-0149 | |
Emerald Coast Autism Center Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 200 Partin Dr N, Niceville, FL 32578 Phone: 850-279-3000 | |
Laney Elle Plum, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 213 Parkwood Cir, Niceville, FL 32578 Phone: 661-932-4074 |