Provider Demographics
NPI:1194923268
Name:SPEECH TIME, INC
Entity type:Organization
Organization Name:SPEECH TIME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HECKSTALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-854-7244
Mailing Address - Street 1:1300 CORAL WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2934
Mailing Address - Country:US
Mailing Address - Phone:305-854-7244
Mailing Address - Fax:786-375-5544
Practice Address - Street 1:1450 CORAL WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2856
Practice Address - Country:US
Practice Address - Phone:305-854-7244
Practice Address - Fax:305-854-7244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Z00000X, 261QM1300X
FLSI10352355S0801X
FLSA606235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891462100Medicaid