Individual provider Active NPI

Jodi Tice De la Torre

  • Speech-Language Pathologist
  • Miami Lakes, FL
National Provider Identifier
1003115809
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA669 Issued in FL
Practice address
5979 NW 151St St
Suite 108
Miami Lakes, FL 33014-2400
Phone
(305) 362-3300
Fax
(305) 362-0202
NPI assigned
Mar 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA669 FL Primary

Addresses

Primary practice location

5979 NW 151St St
Suite 108
Miami Lakes, FL 33014-2400

Mailing address

2731 Oakbrook MNR
Weston, FL 33332-3429
Phone (954) 389-2206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA669FLMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1003115809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 OAKBROOK MNR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333323429",
            "telephone_number": "954-389-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 NW 151ST ST",
            "address_2": "SUITE 108",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142400",
            "telephone_number": "305-362-3300",
            "fax_number": "305-362-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA TORRE",
        "first_name": "JODI",
        "middle_name": "TICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.