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Organization
SPECIALIZED SPEECH CENTER, INC.
Active
Organization
SPECIALIZED SPEECH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TAMBASCO MS/CCC-SLP (VICE-PRESIDENT)
(954) 442-9422
Entity
Organization
Contact information
Practice address
3335 N UNIVERSITY DR, SUITE 5, HOLLYWOOD, FL 33024-2200
(954) 442-9422
(954) 442-9150
Mailing address
3335 N UNIVERSITY DR, SUITE 5, HOLLYWOOD, FL 33024-2200
(954) 442-9422
(954) 442-9150
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT11451
FL
235Z00000X
Speech-Language Pathologist
Primary
SA4906
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015424
AETNA
FL
05
—
830087900
—
FL
05
—
883785600
—
FL
05
—
884371600
—
FL
05
—
884449600
—
FL
01
—
S1795
BC/BS OF FL
FL
01
—
T0757
BC/BS
FL
Enumeration date
02/08/2006
Last updated
02/05/2014
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