Provider Demographics
NPI:1821534942
Name:AMANDA D. BURD, M.S., CCC-SLP, P.A.
Entity Type:Organization
Organization Name:AMANDA D. BURD, M.S., CCC-SLP, P.A.
Other - Org Name:FORT LAUDERDALE SPEECH THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:ENGLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:305-495-0057
Mailing Address - Street 1:110 NORTH FEDERAL HIGHWAY
Mailing Address - Street 2:UNIT 715
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-3511
Mailing Address - Country:US
Mailing Address - Phone:305-495-0057
Mailing Address - Fax:
Practice Address - Street 1:110 NORTH FEDERAL HIGHWAY
Practice Address - Street 2:UNIT 715
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-3511
Practice Address - Country:US
Practice Address - Phone:305-495-0057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12013261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech