Provider Demographics
NPI:1174666770
Name:QUINN, MICHAEL E II (CCC SLP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:QUINN
Suffix:II
Gender:M
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14717 YORKSHIRE RUN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7831
Mailing Address - Country:US
Mailing Address - Phone:407-694-4366
Mailing Address - Fax:407-249-2720
Practice Address - Street 1:14717 YORKSHIRE RUN DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7831
Practice Address - Country:US
Practice Address - Phone:407-694-4366
Practice Address - Fax:407-249-2720
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6010235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist