Selena Seymour Dorestant

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA11649 Issued in FL

Practice address

15204 W Colonial Dr
Winter Garden, FL 34787-6042

Phone

(407) 877-2394

NPI assigned

Jun 1, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1023466976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9814 CRENSHAW CIR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876042",
            "telephone_number": "407-877-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYMOUR DORESTANT",
        "first_name": "SELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.