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Organization
FL MC SPROUT 1, LLC
Active
Organization
FL MC SPROUT 1, LLC
Active
Other names
Elemy
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW NEIDICH (VICE PRESIDENT, NETWORK OPERATIONS)
(917) 648-3846
Entity
Organization
Contact information
Practice address
501 E KENNEDY BLVD, TAMPA, FL 33602-5237
(561) 235-7613
Mailing address
6303 BLUE LAGOON DR STE 400, MIAMI, FL 33126-6040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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