Provider Demographics
NPI:1639571722
Name:PUJOL, CHRISTINE BEVROTTE (MCD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:BEVROTTE
Last Name:PUJOL
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 E NINE MILE RD STE B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-1653
Mailing Address - Country:US
Mailing Address - Phone:850-972-8823
Mailing Address - Fax:850-862-6270
Practice Address - Street 1:1290 E NINE MILE RD STE B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-1653
Practice Address - Country:US
Practice Address - Phone:850-857-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
FL13451235Z00000X
FLSA13451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty