Provider Demographics
NPI:1083361042
Name:EFFECTIVE SPEECH
Entity Type:Organization
Organization Name:EFFECTIVE SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:GARDNER
Authorized Official - Last Name:LEIST
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:813-404-7707
Mailing Address - Street 1:2564 MURRAY PASS
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-4163
Mailing Address - Country:US
Mailing Address - Phone:813-404-7707
Mailing Address - Fax:
Practice Address - Street 1:2564 MURRAY PASS
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-4163
Practice Address - Country:US
Practice Address - Phone:813-404-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008113500Medicaid