Provider Demographics
NPI:1609949577
Name:UNIVERSITY OF FLORIDA SPEECH&HEARING CLINIC
Entity Type:Organization
Organization Name:UNIVERSITY OF FLORIDA SPEECH&HEARING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON-WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:352-392-2041
Mailing Address - Street 1:PO BOX 117420
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-7420
Mailing Address - Country:US
Mailing Address - Phone:352-392-2041
Mailing Address - Fax:352-846-2189
Practice Address - Street 1:435 DAUER HALL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7420
Practice Address - Country:US
Practice Address - Phone:352-392-2041
Practice Address - Fax:352-846-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty