Provider Demographics
NPI:1609200674
Name:ALYSSA N. SHAFII, M.S., CCC-SLP, P.A.
Entity Type:Organization
Organization Name:ALYSSA N. SHAFII, M.S., CCC-SLP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:SHAFII
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:813-784-8802
Mailing Address - Street 1:10601 ASHTEAD WOOD CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2577
Mailing Address - Country:US
Mailing Address - Phone:813-251-4381
Mailing Address - Fax:813-251-6407
Practice Address - Street 1:10601 ASHTEAD WOOD CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2577
Practice Address - Country:US
Practice Address - Phone:813-251-4381
Practice Address - Fax:813-251-6407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10818235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty