Provider Demographics
NPI:1770862955
Name:SEABILITY LLC
Entity Type:Organization
Organization Name:SEABILITY LLC
Other - Org Name:SEABILITY THERAPY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH PATHOLOGIST/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:855-757-4897
Mailing Address - Street 1:PO BOX 510174
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-0174
Mailing Address - Country:US
Mailing Address - Phone:855-757-4897
Mailing Address - Fax:855-757-4897
Practice Address - Street 1:401 OCEAN AVE STE 201A
Practice Address - Street 2:
Practice Address - City:MELBOURNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32951-2568
Practice Address - Country:US
Practice Address - Phone:855-757-4897
Practice Address - Fax:855-757-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Multi-Specialty