Theobald, Afton D
Theobald, Afton D is an sole proprietor health care provider with primary practice located at 12220 Towne Lake Dr Ste 1, Fort Myers FL 33913. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Theobald, Afton D can be contacted via phone (239) 433-6700.Contact Information
Primary practice address
12220 Towne Lake Dr Ste 1
Fort Myers FL 33913
Phone: (239) 433-6700
Fax: (239) 433-6703
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | ||
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA12565 | Florida |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist | 222Q00000X | ||
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X |
Profile Details
| NPI number | 1023379435 |
|---|---|
| LBN Legal business name | Theobald, Afton D |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2012 |
| Last updated | Apr 27th, 2026 - about 6 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023379435 | NPPES |
| Florida | MEDICAID | 009427500 |
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