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BLUE TIDE PEDIATRIC THERAPY LLC NPI 1114654431


NPI Information

NPI: 1114654431
Provider Name: BLUE TIDE PEDIATRIC THERAPY LLC
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization
Address:
2241 N MONROE ST # 1336
TALLAHASSEE, FL
ZIP 32303
Phone: (850) 964-6162
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BLUE TIDE PEDIATRIC THERAPY LLC is a speech language pathologist in Tallahassee, FL. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. BLUE TIDE PEDIATRIC THERAPY LLC NPI is 1114654431. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2241 N MONROE ST # 1336
TALLAHASSEE, FL
ZIP 32303-731
Phone: (850) 964-6162

The provider's authorized official is Garrett Outland .
The authorized official title is Speech-language Pathologist and has the following contact phone number (850) 964-6162.

The enumeration date for this NPI number is 8/5/2022 and was last updated on 8/5/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language PathologistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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