Provider Demographics
NPI:1699010850
Name:MUSGROVE, ANNE MARIE (MA)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:MUSGROVE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 NW 13TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4616
Mailing Address - Country:US
Mailing Address - Phone:205-541-5153
Mailing Address - Fax:352-505-6383
Practice Address - Street 1:250 NW 76TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6668
Practice Address - Country:US
Practice Address - Phone:352-505-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ6092OtherFLORIDA DOH