Provider Demographics
NPI:1306162763
Name:PARADIGM SPEECH CONSULTANTS LLC
Entity type:Organization
Organization Name:PARADIGM SPEECH CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BUTTERS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:863-412-8080
Mailing Address - Street 1:501 CIMAROSA AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-8384
Mailing Address - Country:US
Mailing Address - Phone:863-412-8080
Mailing Address - Fax:863-875-4810
Practice Address - Street 1:612 MAGNOLIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-4108
Practice Address - Country:US
Practice Address - Phone:863-412-8080
Practice Address - Fax:863-875-4810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-10
Last Update Date:2010-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7071261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation