Fresh Start Speech Therapy Services Llc. is a medicare enrolled "Clinic/center" provider in Jacksonville, Florida. Their current practice location is
9957 Moorings Dr Ste 301, Jacksonville, Florida. You can reach out to their office (for appointments etc.) via phone at
(904) 652-6165.
Fresh Start Speech Therapy Services Llc. is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Fresh Start Speech Therapy Services Llc.
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1528591302.
Healthcare Provider's Profile
| Full Name | Fresh Start Speech Therapy Services Llc. |
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| Type | Facility |
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| Speciality | Clinic/center |
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| Location | 9957 Moorings Dr Ste 301, Jacksonville, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1528591302
- Provider Enumeration Date: 04/07/2017
- Last Update Date: 05/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 3173890969
- Enrollment ID: O20170526001315
Medical Identifiers
Medical identifiers for Fresh Start Speech Therapy Services Llc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528591302 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 2355S0801X | Specialist/technologist - Speech-language Assistant | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QH0700X | Clinic/center - Hearing And Speech | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Fresh Start Speech Therapy Services Llc. acts as a billing entity for following providers:
| Provider Name | Khalilah Marques |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1932478153
PECOS PAC ID: 4082981873
Enrollment ID: I20170619002889 |
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| Provider Name | Velinda Utile |
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| Provider Type | Practitioner - Occupational Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1972216281
PECOS PAC ID: 5991166118
Enrollment ID: I20230803001069 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fresh Start Speech Therapy Services Llc. is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Fresh Start Speech Therapy Services Llc.
9957 Moorings Dr Ste 301,
Jacksonville, FL 32257-2415
Ph: (904) 652-6165 | Fresh Start Speech Therapy Services Llc.
9957 Moorings Dr Ste 301,
Jacksonville, FL 32257-2415
Ph: (904) 652-6165 |
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