Provider Demographics
NPI:1518577139
Name:SVOBODA, ANNIKA (SLP)
Entity Type:Individual
Prefix:
First Name:ANNIKA
Middle Name:
Last Name:SVOBODA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 87TH PL N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-6241
Mailing Address - Country:US
Mailing Address - Phone:907-982-9613
Mailing Address - Fax:
Practice Address - Street 1:3025 87TH PL N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-6241
Practice Address - Country:US
Practice Address - Phone:907-982-9613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3615235Z00000X
FLSA20241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist