Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Fullsail Therapy Service, LLC

Organization Speech-Language Pathologist · NPI 1487352662

Fullsail Therapy Service, LLC is a Speech-Language Pathologist in Tavares, Florida. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2760 Dora Ave
Tavares, FL 32778-4970
Phone: (352) 455-3079
Fax: (352) 508-5113
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X

Record details

NPI number1487352662
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dolly Nieves — Directory Of Therapy · (407) 529-5719
NPI enumeratedFebruary 17, 2023
Last updated in NPPESFebruary 17, 2023
Certification dateFebruary 17, 2023
Mailing address19126 Park Place Blvd, Eustis, FL 32736-7261

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