Provider Demographics
NPI:1841561305
Name:SPEECHBUILDERS LLC
Entity Type:Organization
Organization Name:SPEECHBUILDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:407-703-2700
Mailing Address - Street 1:235 E. 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703
Mailing Address - Country:US
Mailing Address - Phone:407-703-2711
Mailing Address - Fax:407-910-2923
Practice Address - Street 1:235 E. 5TH STREET
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703
Practice Address - Country:US
Practice Address - Phone:407-703-2711
Practice Address - Fax:407-910-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-14
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7338235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005964700Medicaid
FL891325100Medicaid