Provider Demographics
NPI:1518126846
Name:LEMON TREE LLC
Entity Type:Organization
Organization Name:LEMON TREE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARAVANOS
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:813-854-3000
Mailing Address - Street 1:3885 TAMPA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3121
Mailing Address - Country:US
Mailing Address - Phone:813-854-3000
Mailing Address - Fax:813-854-3002
Practice Address - Street 1:3885 TAMPA RD
Practice Address - Street 2:SUITE A
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3121
Practice Address - Country:US
Practice Address - Phone:813-854-3000
Practice Address - Fax:813-854-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5567261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887483200Medicaid