Provider Demographics
NPI:1033513387
Name:SPECTRUM SPEECH SOLUTIONS, INC.
Entity Type:Organization
Organization Name:SPECTRUM SPEECH SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PERRETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MMS SLP
Authorized Official - Phone:914-671-5822
Mailing Address - Street 1:18064 107TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-1620
Mailing Address - Country:US
Mailing Address - Phone:914-671-5822
Mailing Address - Fax:561-533-9918
Practice Address - Street 1:18064 107TH AVE S
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-1620
Practice Address - Country:US
Practice Address - Phone:914-671-5822
Practice Address - Fax:561-533-9918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9488430052Medicaid