Individual ProviderJanet MoultonSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address2348 South Third Street, Jacksonville Beach, FL 32250(904) 249-8893PECOS EnrollmentBased on the most recent information from CMS, provider Janet Moulton does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1770705725Provider TypeIndividualFull NameMoulton, JanetCredentialCCC-SLPGenderFemaleSole ProprietorNoEnumeration Date5/2/2007Last Updated7/9/2007Contact InformationPractice LocationPractice Address2348 South Third Street, Jacksonville Beach, FL 32250Phone(904) 249-8893Fax(904) 246-7259Mailing LocationMailing Address1138 Sandpiper Lane East, Atlantic Beach, FL 32233Phone(904) 249-8893Fax(904) 246-7259Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseSA4951FloridaProvider IdentifiersIDDescriptionIssuerID372866DescriptionOtherIssuerWELLCARE IDFloridaID700656DescriptionOtherIssuerACN GROUPFloridaIDS1828DescriptionOtherIssuerBCBS IDFloridaID884273600DescriptionMedicaidIssuerUnlistedFlorida