Provider Demographics
NPI:1235638024
Name:SAMADELLO DE BRITO, ANDREA CRISTINA (MS CFY-SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CRISTINA
Last Name:SAMADELLO DE BRITO
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 LAKE UNDERHILL RD STE 260
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4508
Mailing Address - Country:US
Mailing Address - Phone:407-249-3344
Mailing Address - Fax:407-378-2978
Practice Address - Street 1:12301 LAKE UNDERHILL RD STE 260
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist