Doctor Name: | SHELBY P MIRABELLI |
NPI Number: | 1053746834 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SZ6374 |
Business Practice Address: | 4401 E Colonial Dr Suite 107 Orlando, FL - 328035200 |
Business Phone Number: | 4078985060 |
Business Fax Number: | 4078985185 |
Mailing Address: | 4401 E Colonial Dr, Suite 107 ORLANDO |
State: | FL |
Postal Code: | 328035200 |
Phone Number: | 4078985060 |
Fax Number: | 4078985185 |
NPI Enumeration Date: | 09/11/2013 |
NPI Last Update Date: | 09/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ6374 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |