Provider Demographics
NPI:1881987592
Name:NAGELE, AMBER BROOKE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:BROOKE
Last Name:NAGELE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 GOLFVIEW RD APT C
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3569
Mailing Address - Country:US
Mailing Address - Phone:561-360-6024
Mailing Address - Fax:
Practice Address - Street 1:388 GOLFVIEW RD APT C
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-360-6024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL282196174N00000X
FLSA11627235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA11627OtherDEPT. OF HEALTH
FL0035999700Medicaid