Provider Demographics
NPI:1508141532
Name:PANELS, FLORIA G (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:FLORIA
Middle Name:G
Last Name:PANELS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 FREMONT RD
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-2696
Mailing Address - Country:US
Mailing Address - Phone:315-434-3002
Mailing Address - Fax:
Practice Address - Street 1:407 FREMONT RD
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-2696
Practice Address - Country:US
Practice Address - Phone:315-434-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003136-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist