Organization
LIGHTHOUSE THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. INGRID ACOSTA SLPA (SLPA)
(407) 990-2847
Entity
Organization
Contact information
Practice address
1225 GARDEN ISLE CT, ORLANDO, FL 32824-6218
(407) 990-2847
Mailing address
1225 GARDEN ISLE CT, ORLANDO, FL 32824-6218
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
SI2530
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019005100
—
FL
Enumeration date
07/17/2018
Last updated
07/17/2018
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