Individual
FELICIA NICOLE PASTORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
6508 GUNN HWY, TAMPA, FL 33625-4022
(813) 963-6923
Mailing address
6508 GUNN HWY, TAMPA, FL 33625-4022
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA17525
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100903000
—
FL
Enumeration date
09/14/2018
Last updated
12/02/2022
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