Ponte Vedra Speech Language And Learning Llc is a medicare enrolled "Clinic/center" provider in Ponte Vedra, Florida. Their current practice location is
30 Tavernier Dr Unit B, Ponte Vedra, Florida. You can reach out to their office (for appointments etc.) via phone at
(904) 404-2345.
Ponte Vedra Speech Language And Learning Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Ponte Vedra Speech Language And Learning 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 1770262990.
Healthcare Provider's Profile
| Full Name | Ponte Vedra Speech Language And Learning Llc |
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| Type | Facility |
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| Speciality | Clinic/center |
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| Location | 30 Tavernier Dr Unit B, Ponte Vedra, 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: 1770262990
- Provider Enumeration Date: 07/14/2023
- Last Update Date: 05/13/2025
Medicare PECOS Information:
- PECOS PAC ID: 6406390665
- Enrollment ID: O20240628000141
Medical Identifiers
Medical identifiers for Ponte Vedra Speech Language And Learning Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770262990 | NPI | - | NPPES |
| 124351900 | Medicaid | FL | |
| SA22939 | Other | FL | FLORIDA BOARD OF SPEECH-LANGAUGE PATHOLOGY AND AUTUMN WOOD |
| SA19092 | Other | FL | FLORIDA BOARD OF SPEECH-LANGAUGE PATHOLOGY AND AUDIOLOGY SONYA OLSEN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ponte Vedra Speech Language And Learning Llc acts as a billing entity for following providers:
| Provider Name | Sonya Marie Olsen |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1295291177
PECOS PAC ID: 7214471473
Enrollment ID: I20240628000169 |
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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. Ponte Vedra Speech Language And Learning 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 |
|---|
Ponte Vedra Speech Language And Learning Llc
30 Tavernier Dr Unit B,
Ponte Vedra, FL 32081-0677
Ph: (904) 404-2345 | Ponte Vedra Speech Language And Learning Llc
30 Tavernier Dr Unit B,
Ponte Vedra, FL 32081-0677
Ph: (904) 404-2345 |
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