Koren Lynn Tolentino | Jacksonville, FL • PECOS Search

Koren Lynn Tolentino

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

14444 Beach Blvd, Suite 500, Jacksonville, FL 32250-2079

(904) 858-7510 (904) 223-1075

PECOS Enrollment

Based on the most recent information from CMS, provider Koren Lynn Tolentino does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1225164106
Provider Type
Individual
Full Name
Tolentino, Koren Lynn
Title
Mrs.
Credential
CCC-SLP

Gender
Female
Sole Proprietor
No
Enumeration Date
2/26/2007
Last Updated
7/8/2007

Contact Information

Practice Location

14444 Beach Blvd, Suite 500, Jacksonville, FL 32250-2079

(904) 858-7540

Mailing Location

13364 Beach Blvd Unit 204, Jacksonville, FL 32224-0265

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License SA8896 Florida