Individual provider Active NPI

Odalis Abreu, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Hialeah, FL
National Provider Identifier
1043578636
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA12516 Issued in FL
Practice address
922 E 26TH St
Hialeah, FL 33013-3411
Phone
(786) 253-7230
NPI assigned
May 2, 2012
Last updated
Dec 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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 SA12516 FL Primary

Addresses

Primary practice location

922 E 26TH St
Hialeah, FL 33013-3411

Mailing address

922 E 26TH St
Hialeah, FL 33013-3411
Phone (786) 253-7230

Other identifiers 1

IdentifierTypeStateIssuer
005939900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA12516FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
B & V Thera Pro Associates Corp Speech-Language Pathologist CurrentSince Jan 7, 2013 Accepting new patients

Locations

14291 SW 120th St
Ste 103
Miami, FL 33186
Phone (305) 385-0168

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1043578636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 E 26TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133411",
            "telephone_number": "786-253-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 E 26TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133411",
            "telephone_number": "786-253-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABREU",
        "first_name": "ODALIS",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005939900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

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