Provider Demographics
NPI:1053650192
Name:MIKITA, STEVE FRANCIS (SLP)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:FRANCIS
Last Name:MIKITA
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9690 PINE TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2366
Mailing Address - Country:US
Mailing Address - Phone:561-969-2983
Mailing Address - Fax:
Practice Address - Street 1:1626 DAVIS RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5640
Practice Address - Country:US
Practice Address - Phone:561-439-8897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-09
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2565235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist