Jaqualine Fort, SLP-CFY

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ5745 Issued in FL

Practice address

1000 Savage CT Ste 101
Longwood, FL 32750-4988

Phone

(407) 271-4911

Fax

(407) 264-8344

NPI assigned

Mar 6, 2012

Last updated

Mar 6, 2012By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1043584295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 ECON CIR APT 183",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328172691",
            "telephone_number": "407-937-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SAVAGE CT STE 101",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504988",
            "telephone_number": "407-271-4911",
            "fax_number": "407-264-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORT",
        "first_name": "JAQUALINE",
        "name_prefix": "Mrs.",
        "credential": "SLP-CFY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ5745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Longwood, FL
• Providers in Longwood, 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 Mar 6, 2012; 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.