Provider Demographics
NPI:1851881304
Name:SUNSHINE SPEECH LANGUAGE PATHOLOGY CORP
Entity Type:Organization
Organization Name:SUNSHINE SPEECH LANGUAGE PATHOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOGELI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:772-486-3328
Mailing Address - Street 1:2585 SW EGRET POND CIR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2536
Mailing Address - Country:US
Mailing Address - Phone:772-486-3328
Mailing Address - Fax:
Practice Address - Street 1:2585 SW EGRET POND CIR
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2536
Practice Address - Country:US
Practice Address - Phone:772-486-3328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty