Provider Demographics
NPI:1427342179
Name:FEISTHAMMEL, MARTHA JULIANA (CCC/SLP)
Entity type:Individual
Prefix:
First Name:MARTHA JULIANA
Middle Name:
Last Name:FEISTHAMMEL
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:MARTHA JULIANA
Other - Middle Name:
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4352
Mailing Address - Country:US
Mailing Address - Phone:321-256-3050
Mailing Address - Fax:
Practice Address - Street 1:305 E OAK ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4352
Practice Address - Country:US
Practice Address - Phone:321-256-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 5388235Z00000X
FLSA11575235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist