Active NPI
Kasandra Rose Villalon, M.S. CCC-SLP
- Speech-Language Pathologist
- Palmetto, FL
National Provider Identifier
1003679812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA21511
- Practice address
- 1815 5TH St W
Palmetto, FL 34221-4309 - Phone
- (941) 348-7562
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Speech-Language Pathologist | 235Z00000X | SA21511 | FL | Primary |
Addresses
Primary practice location
1815 5TH St W
Palmetto, FL 34221-4309
Mailing address
1815 5TH St W
Palmetto, FL 34221-4309
Phone (941) 348-7562
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA21511 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717372800000",
"number": "1003679812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 5TH ST W",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342214309",
"telephone_number": "941-348-7562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 5TH ST W",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342214309",
"telephone_number": "941-348-7562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLALON",
"first_name": "KASANDRA",
"middle_name": "ROSE",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-06-03",
"certification_date": "2024-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA21511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmetto, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.