Individual provider Active NPI

Maliyah Renae Wiseman

  • Speech-Language Assistant
  • Kissimmee, FL
National Provider Identifier
1053202424
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
8121 Issued in FL
Practice address
1107 Mabbette St
Kissimmee, FL 34741-5161
Phone
(407) 201-8079
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X FL
Speech-Language Assistant 2355S0801X 8121 FL Primary

Addresses

Primary practice location

1107 Mabbette St
Kissimmee, FL 34741-5161

Mailing address

11342 Great Commission Way
Orlando, FL 32832-7066
Phone (321) 591-8564

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8121FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yakety Yak Speech-Language Pathologists, Inc. CurrentSince Jul 22, 2025 Accepting new patients
Yakety Yak Speech-Language Pathologists, Inc. Speech-Language Assistant PastSince Jul 22, 2025 Accepting new patients

Locations

1107 Mabbette St
Kissimmee, FL 34741
Phone (407) 201-8079

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, 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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1053202424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11342 GREAT COMMISSION WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328327066",
            "telephone_number": "321-591-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MABBETTE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415161",
            "telephone_number": "407-201-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "MALIYAH",
        "middle_name": "RENAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "8121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.