Basic Information
Provider Information
NPI: 1629148549
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAY
FirstName: ANNETTE
MiddleName: HAMNER
NamePrefix:  
NameSuffix:  
Credential: CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 S ORANGE AVE
Address2:  
City: ORLANDO
State: FL
PostalCode: 328062134
CountryCode: US
TelephoneNumber: 4076483800
FaxNumber: 4074255203
Practice Location
Address1: 1400 S ORANGE AVE
Address2:  
City: ORLANDO
State: FL
PostalCode: 328062134
CountryCode: US
TelephoneNumber: 4076483800
FaxNumber: 4074255203
Other Information
ProviderEnumerationDate: 11/08/2006
LastUpdateDate: 02/25/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XSA8633FLN Speech, Language and Hearing Service ProvidersAudiologist 
235Z00000XSA8633FLY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

ID Information
IDTypeStateIssuerDescription
SA863301FLMEDICAL LICENSEOTHER


Home