Provider Demographics
NPI:1750075073
Name:UNITED SPEECH AND REHABILITATIVE THERAPY LLC
Entity type:Organization
Organization Name:UNITED SPEECH AND REHABILITATIVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:COMAS
Authorized Official - Last Name:BARDELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-294-3936
Mailing Address - Street 1:18567 SW 132ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1527 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-3815
Practice Address - Country:US
Practice Address - Phone:786-294-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No253Z00000XAgenciesIn Home Supportive Care