Individual provider · NPI-1

Daylise Allen-Polidore

Speech-Language Pathologist, · Lutz, FL

NPI number1316797251
StatusActive
Last updated in NPPESJun 10, 2026

Details

NPI
1316797251
Entity type
Individual (NPI-1)
Name
Daylise Allen-Polidore
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 25, 2024
Certification date
Jun 10, 2026
Last updated
Jun 10, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,SZ13320FLYes
2355S0801X Specialist/Technologist, Speech-Language AssistantSI6976FL

Practice location

207 Crystal Grove Blvd
Lutz, FL 33548-6409

Phone 813-848-0341

Mailing address

9827 Montague St
Tampa, FL 33626-1863

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