Provider Demographics
NPI:1477993798
Name:A SORELLS SPEECH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:A SORELLS SPEECH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:SORELLS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:904-701-3512
Mailing Address - Street 1:8613 OLD KINGS RD STE 601
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4807
Mailing Address - Country:US
Mailing Address - Phone:904-537-6911
Mailing Address - Fax:888-343-8381
Practice Address - Street 1:8613 OLD KINGS RD STE 601
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4807
Practice Address - Country:US
Practice Address - Phone:904-537-6911
Practice Address - Fax:888-343-8381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty