Bianca Alexis Rego, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA17984 Issued in FL

Practice address

17901 NW 5TH St Ste 201
Pembroke Pines, FL 33029-2810

Phone

(954) 606-5439

Fax

(954) 606-5430

NPI assigned

Jan 4, 2021

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

Credentials

Master of Science

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.

• Konfetti Kidz Therapy

  • Clinic/Center
  • Pembroke Pines, FL
  • NPI 1508389644

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1023606282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20030 NW 5TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293318",
            "telephone_number": "954-401-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 NW 5TH ST STE 201",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292810",
            "telephone_number": "954-606-5439",
            "fax_number": "954-606-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGO",
        "first_name": "BIANCA",
        "middle_name": "ALEXIS",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2020-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Pembroke Pines, FL
• Providers in Pembroke Pines, 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 Jan 4, 2021; 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.