Provider Demographics
NPI:1114242955
Name:CAMARDA SPEECH & LANGUAGE GROUP, LLC
Entity Type:Organization
Organization Name:CAMARDA SPEECH & LANGUAGE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITNI
Authorized Official - Middle Name:G
Authorized Official - Last Name:CAMARDA
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC/SLP
Authorized Official - Phone:772-323-7576
Mailing Address - Street 1:764 SE RIVER CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2775
Mailing Address - Country:US
Mailing Address - Phone:772-323-7576
Mailing Address - Fax:772-224-2517
Practice Address - Street 1:764 SE RIVER CT
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2775
Practice Address - Country:US
Practice Address - Phone:772-323-7576
Practice Address - Fax:772-224-2517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8537235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty