Provider Demographics
NPI:1992738223
Name:SPADARO, ANGELA S (MA CCC SLP)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:S
Last Name:SPADARO
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2179 EOLA CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8028
Mailing Address - Country:US
Mailing Address - Phone:407-898-5060
Mailing Address - Fax:407-898-5185
Practice Address - Street 1:4401 E COLONIAL DR STE 107
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5200
Practice Address - Country:US
Practice Address - Phone:407-898-5060
Practice Address - Fax:407-898-5185
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7099235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist