Excellerated Teaching Center
Clinic/Center in St Petersburg, FL. Organization (NPI-2).
NPI number1669040366
StatusActive
Last updated in NPPESJun 17, 2021
Details
- NPI
- 1669040366
- Entity type
- Organization (NPI-2)
- Legal business name
- Excellerated Teaching Center
- Organization subpart
- Yes
- Enumeration date
- Jun 17, 2021
- Certification date
- Jun 17, 2021
- Last updated
- Jun 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
5175 45th St NSt Petersburg, FL 33714-2266
Phone 727-748-4060 · Fax 727-748-4060
Mailing address
5175 45th St NSt Petersburg, FL 33714-2266
Phone 727-748-4060 · Fax 727-748-4060
Authorized official
Robert Jones Hasbrouck
Owner
7277484060
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