Individual provider Active NPI

Mindy Selber, SA 6191

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1043376585
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 6191 Issued in FL
Practice address
3305 S Orange Ave
Orlando, FL 32806-6125
Phone
(407) 852-3310
Fax
(407) 852-3301
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA 6191 FL Primary

Addresses

Primary practice location

3305 S Orange Ave
Orlando, FL 32806-6125

Mailing address

3305 S Orange Ave
Orlando, FL 32806-6125
Phone (407) 852-3310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250326003648 FL Practitioner - Qualified Speech Language Pathologist 2365965712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Univ of Central Florida, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sobe Innovative Rehabilitation PLLCGroup PAC ID 4789994336, 178 clinicians

Practice addresses (Care Compare)

6855 NW 70TH Ave
Harborchase of Tamarac
Tamarac, FL 33321-5326
Phone (786) 770-9480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA 6191FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sobe Innovative Rehabilitation PLLC Speech-Language Pathologist CurrentSince Feb 6, 2025 Accepting new patients
Strength and Balance Institute Speech-Language Pathologist PastSince Aug 11, 2019 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

6855 NW 70th Ave
Tamarac, FL 33321
Phone (954) 224-8359

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1043376585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066125",
            "telephone_number": "407-852-3310",
            "fax_number": "407-852-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328066125",
            "telephone_number": "407-852-3310",
            "fax_number": "407-852-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBER",
        "first_name": "MINDY",
        "name_prefix": "Mrs.",
        "credential": "SA 6191",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 6191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.