Provider Demographics
NPI:1497225130
Name:GREGORIO, DAVID (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GREGORIO
Suffix:
Gender:M
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 N ORANGE AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1070
Mailing Address - Country:US
Mailing Address - Phone:727-282-2764
Mailing Address - Fax:
Practice Address - Street 1:1858 N ALAFAYA TRL STE 207
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4754
Practice Address - Country:US
Practice Address - Phone:407-900-5313
Practice Address - Fax:888-972-5443
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8654235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist