Provider Demographics
NPI:1922727346
Name:PLOURDE, MAGGIE J (MS)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:J
Last Name:PLOURDE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36915 BLANTON RD
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33523-2204
Mailing Address - Country:US
Mailing Address - Phone:352-206-8442
Mailing Address - Fax:
Practice Address - Street 1:5424 LAND O LAKES BLVD
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-3453
Practice Address - Country:US
Practice Address - Phone:813-996-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist