Provider Demographics
NPI:1194196592
Name:DYSPHAGIA MANAGEMENT SYSTEMS, LLC
Entity Type:Organization
Organization Name:DYSPHAGIA MANAGEMENT SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:GHIGLIERI
Authorized Official - Last Name:WINCHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS SLP CCC
Authorized Official - Phone:941-320-8930
Mailing Address - Street 1:7819 BERGAMO AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-4759
Mailing Address - Country:US
Mailing Address - Phone:941-320-8930
Mailing Address - Fax:
Practice Address - Street 1:5681 BENTGRASS DR
Practice Address - Street 2:#104
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-7639
Practice Address - Country:US
Practice Address - Phone:941-320-8930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2829261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech