FAME SPEECH AND MYO
NPI 1619622859
Speech-Language Pathologist in Jacksonville, FL

Active since February 16, 2022
13490 GRAN BAY PKWY APT 732, JACKSONVILLE, FL 32258(717) 875-0962 Get Directions Write a Review

NPPES record last updated: November 4, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 4, 2022, Feb 16, 2022 (2 updates tracked since 2022).

  • Organization
  • Speech-Language Pathologist

About FAME SPEECH AND MYO

This page provides the complete NPI Profile along with additional information for Fame Speech And Myo, a provider established in Jacksonville, Florida operating as a Speech-language Pathologist. The healthcare provider is registered in the NPI registry with number 1619622859 assigned on February 2022. The practitioner's primary taxonomy code is 235Z00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Fame Speech And Myo operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Alexa Stubenrauch Ms Ccc-slp (Speech Language Pathologist)

NPI
1619622859 Verify this NPI
Provider Name
FAME SPEECH AND MYO
Entity Type
Organization
Location Address
13490 GRAN BAY PKWY APT 732 JACKSONVILLE, FL 32258
Location Phone
(717) 875-0962
Mailing Address
178 VISTA GRANDE DR PONTE VEDRA BEACH, FL 32082
Mailing Phone
(717) 875-0962
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-16-2022
Last Update Date
11-04-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Speech-Language Pathologist

Taxonomy Code
235Z00000X
Type
Speech, Language and Hearing Service Providers
Taxonomy Description
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ALEXA STUBENRAUCH MS CCC-SLP

Authorized Official Title
SPEECH LANGUAGE PATHOLOGIST
Authorized Official Phone
(717) 875-0962

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619622859, enumerated as an "organization" on February 16, 2022.

The provider is located at 13490 GRAN BAY PKWY APT 732 JACKSONVILLE, FL 32258 and the phone number is (717) 875-0962.

Speech-Language Pathologist with taxonomy code 235Z00000X.