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Organization
TREASURE COAST SWALLOWING DIAGNOSTICS INC
Active
Organization
TREASURE COAST SWALLOWING DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CHRISTOPHER GAUGHRAN M.S. CCC-SLP (PRESIDENT)
(954) 249-1693
Entity
Organization
Contact information
Practice address
64 JOY HAVEN DR, SEBASTIAN, FL 32958-6282
(954) 249-1693
Mailing address
64 JOY HAVEN DR, SEBASTIAN, FL 32958-6282
(954) 249-1693
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 7547
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013971159
INDIVIDUAL NPI
FL
Enumeration date
06/14/2012
Last updated
06/14/2012
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