Provider Demographics
NPI:1669989562
Name:MADDEN THERAPY SOLUTIONS, PLLC
Entity type:Organization
Organization Name:MADDEN THERAPY SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:MADDEN
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:727-240-6209
Mailing Address - Street 1:5919 BAYOU GRANDE BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-1821
Mailing Address - Country:US
Mailing Address - Phone:727-240-6209
Mailing Address - Fax:
Practice Address - Street 1:10901 ROOSEVELT BLVD N STE 800
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-2305
Practice Address - Country:US
Practice Address - Phone:727-240-6209
Practice Address - Fax:727-674-2545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL238357174N00000X
261Q00000X
FLSA9459235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty