Provider Demographics
NPI:1831088806
Name:PRIMECARE SPEECH SERVICES LLC
Entity type:Organization
Organization Name:PRIMECARE SPEECH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLGIST
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:954-789-1694
Mailing Address - Street 1:220 SE 2ND ST APT 1218
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-4183
Mailing Address - Country:US
Mailing Address - Phone:954-789-1694
Mailing Address - Fax:
Practice Address - Street 1:220 SE 2ND ST APT 1218
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-4183
Practice Address - Country:US
Practice Address - Phone:954-789-1694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care