Mariam Baez, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA15253 Issued in FL

Practice address

427 Burns Ave
Lake Wales, FL 33853-3314

Phone

(863) 679-3338

NPI assigned

Aug 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kids Connection Therapy LLC

  • Speech-Language Pathologist
  • Longwood, FL
  • NPI 1114691904
  NPD (past)
• Pediatric Therapy Services of Greater Orlando, LLC

  • Occupational Therapist
  • Winter Garden, FL
  • NPI 1013926187

  Speech-Language Pathologist

  NPD (past)
• Victory Ridge Academy, Inc.

  • Clinic/Center
  • Lake Wales, FL
  • NPI 1184044612

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1003283128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 BURNS AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533314",
            "telephone_number": "863-679-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 BURNS AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533314",
            "telephone_number": "863-679-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "MARIAM",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015667300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yashekia D'Wan Atmore
• Ava Rehabilitation Clinic
• Martin Avellaneda Jr.
• Caren Azurin, PHARMD
• Richard Keith Bachman, M.D.
• Jean Fritzner Balan, M.D.
• Bangash Dentistry PLLC
• Maryam Bangash
• Santelia Barnes
• Heather Watson Barranco

• All providers in Lake Wales, FL
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.