NPIMap

Organization Active NPI

Nicole Lilienthal, Ms, CCC-SLP, PA

  • Speech-Language Pathologist
  • Ft Lauderdale, FL
National Provider Identifier
1043338775
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA5711 Issued in FL
Legal business name
NICOLE LILIENTHAL, MS, CCC-SLP, PA
Practice address
340 Sunset Dr Apt 410
Ft Lauderdale, FL 33301-2640
Phone
(954) 478-4192
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Nicole Miezejeski Lilienthal, MS, CCC-SLP
Title
President
Phone
(954) 478-4192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA5711 FL Primary

Addresses

Primary practice location

340 Sunset Dr Apt 410
Ft Lauderdale, FL 33301-2640

Mailing address

340 Sunset Dr Apt 410
Ft Lauderdale, FL 33301-2640
Phone (954) 478-4192

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043338775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 SUNSET DR APT 410",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012640",
            "telephone_number": "954-478-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 SUNSET DR APT 410",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012640",
            "telephone_number": "954-478-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE LILIENTHAL, MS, CCC-SLP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LILIENTHAL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "MIEZEJESKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-478-4192",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.