Provider Demographics
NPI:1700488947
Name:VIRTUALLY SPEAKING, LLC
Entity type:Organization
Organization Name:VIRTUALLY SPEAKING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TERANYA
Authorized Official - Middle Name:SHAYE
Authorized Official - Last Name:BOYKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-462-3030
Mailing Address - Street 1:5130 S FLORIDA AVE STE 411
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2539
Mailing Address - Country:US
Mailing Address - Phone:863-732-9955
Mailing Address - Fax:863-210-2157
Practice Address - Street 1:6924 KRENSON OAKS ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-2160
Practice Address - Country:US
Practice Address - Phone:407-462-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1801034160Medicaid
FL1487870549Medicaid