Joseph Prusas IV, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA10232 Issued in FL

Practice address

124 Briarwood LN
Cocoa, FL 32926-5937

Phone

(321) 698-7639

NPI assigned

Sep 4, 2020

Last updated

Sep 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1033723234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 BRIARWOOD LN",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329265937",
            "telephone_number": "321-222-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 BRIARWOOD LN",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329265937",
            "telephone_number": "321-698-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSAS",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA10232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Cocoa, FL
• Providers in Cocoa, 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 Sep 10, 2020; 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.