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Individual

MRS. AMBER MORTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
602 VONDERBURG DRIVE, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644
Mailing address
602 VONDERBURG DRIVE, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA11391
FL
235Z00000X
Speech-Language Pathologist
SZ5258
FL

Other

Enumeration date
10/18/2010
Last updated
04/24/2012
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