Provider Demographics
NPI:1518640069
Name:SUNSHINE SPEECH BUDS LLC
Entity Type:Organization
Organization Name:SUNSHINE SPEECH BUDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JURGENS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:516-382-1771
Mailing Address - Street 1:204 37TH AVE N # 186
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1416
Mailing Address - Country:US
Mailing Address - Phone:516-382-1771
Mailing Address - Fax:
Practice Address - Street 1:11150 4TH ST N APT 3801
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-2906
Practice Address - Country:US
Practice Address - Phone:516-382-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty