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Organization
GAIL M VAN TATENHOVE, PA
Active
Organization
GAIL M VAN TATENHOVE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAIL M VAN TATENHOVE MS, CCC-SLP, PA (PRESIDENT)
(407) 876-3423
Entity
Organization
Contact information
Practice address
8322 TANGELO TREE DR, ORLANDO, FL 32836-5437
(407) 876-3423
(407) 876-2120
Mailing address
8322 TANGELO TREE DR, ORLANDO, FL 32836-5437
(407) 876-3423
(407) 876-2120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA318
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
671119796
MEDICAID WAIVER
FL
05
—
886506000
—
FL
Enumeration date
09/21/2006
Last updated
04/24/2008
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