Provider Demographics
NPI:1639529969
Name:PEKAR, BETH AMATO (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:AMATO
Last Name:PEKAR
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:MISS
Other - First Name:BETH
Other - Middle Name:JANEEN
Other - Last Name:AMATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC/SLP
Mailing Address - Street 1:3840 BRANDY ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-5125
Mailing Address - Country:US
Mailing Address - Phone:407-748-3503
Mailing Address - Fax:
Practice Address - Street 1:1222 WINTER GARDEN VINELAND RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4449
Practice Address - Country:US
Practice Address - Phone:407-395-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5218235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist