Provider Demographics
NPI:1710118245
Name:SPEAKWELLINTERNATIONAL LLC
Entity Type:Organization
Organization Name:SPEAKWELLINTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MERIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC-SLP
Authorized Official - Phone:813-727-3123
Mailing Address - Street 1:10002 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7768
Mailing Address - Country:US
Mailing Address - Phone:813-727-3123
Mailing Address - Fax:813-374-2674
Practice Address - Street 1:10002 FOREST HILLS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7768
Practice Address - Country:US
Practice Address - Phone:813-727-3123
Practice Address - Fax:813-374-2674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004248500OtherEARLY INTERVENTIONIST- MEDICAID
FL886381400Medicaid