Active NPI
Daniella Lopez
- Speech-Language Pathologist
- Wildwood, FL
National Provider Identifier
1063341519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA21659
- Practice address
- 109 Wildwood Ave
Wildwood, FL 34785-4221 - Phone
- (786) 715-7030
- Fax
- (786) 715-7030
- NPI assigned
- May 19, 2026
- Last updated
- May 19, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA21659 | FL | Primary |
Addresses
Primary practice location
109 Wildwood Ave
Wildwood, FL 34785-4221
Mailing address
109 Wildwood Ave
Wildwood, FL 34785-4221
Phone (786) 715-7030
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
| License | State | Type | Specialty |
|---|---|---|---|
| SA21659 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779148800000",
"number": "1063341519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 WILDWOOD AVE",
"city": "WILDWOOD",
"state": "FL",
"postal_code": "347854221",
"telephone_number": "786-715-7030",
"fax_number": "786-715-7030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 WILDWOOD AVE",
"city": "WILDWOOD",
"state": "FL",
"postal_code": "347854221",
"telephone_number": "786-715-7030",
"fax_number": "786-715-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "DANIELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-19",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA21659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wildwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.